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General NPI Number Information
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NPI Number | 1679080949
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Entity Type | Individual
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Provider Name | SHIVA AKHAVAN HIS
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Gender | Female
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Dates
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Enumeration Date | 01/08/2018
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Last Update Date | 01/08/2018
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Provider Practice Location Address
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Address Line | 18643 BROOKHURST ST STE 1D
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-6709
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Country | US
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Telephone | 949-535-1845
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Fax | 949-535-1845
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Provider Business Mailing Address
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Address Line | 215 SHUMAN BLVD STE 401
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City | NAPERVILLE
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State | IL
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Zip | 60563-8123
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Country | US
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Telephone | 630-303-5380
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Fax | 630-303-5385
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 8263
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License Number State | CA
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