=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912103326
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEARING AID SYSTEMS, INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/22/2007
-----------------------------------------------------
Last Update Date | 11/05/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 41800 ENTERPRISE CIR S SUITE A
-----------------------------------------------------
City | TEMECULA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92590-4831
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-296-1600
-----------------------------------------------------
Fax | 951-296-1602
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 41800 ENTERPRISE CIR S SUITE A
-----------------------------------------------------
City | TEMECULA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92590-4831
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 951-296-1600
-----------------------------------------------------
Fax | 951-296-1602
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DON TUCKER
-----------------------------------------------------
Credential | H.A.D.
-----------------------------------------------------
Telephone | 951-296-1600
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332S00000X
-----------------------------------------------------
Taxonomy Name | Hearing Aid Equipment
-----------------------------------------------------
License Number | HA2630
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------