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NPI Code Detail

MEDICARE: ADVANCED HEARING AIDS

MEDICARE: ADVANCED HEARING AIDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237700000XHearing Instrument SpecialistHA 1932CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2ZZZ45183ZOTHERCABLUE SHIELD OF CALIFORNIA

General Provider Information

NPI Number : 1124186838
Entity Type Code : Organization
Provider Name (Legal Business Name) : ADVANCED HEARING AIDS
Provider Business Mailing Address
First Line : 56970 YUCCA TRL # 102
Second Line :
City : YUCCA VALLEY
State : CA
Zip : 92284-3753
Country : US
Telephone Number : 760-365-0691
Fax Number : 760-365-0692
Provider Business Practice Location Address
First Line : 56970 YUCCA TRL # 102
Second Line :
City : YUCCA VALLEY
State : CA
Zip : 92284-3753
Country : US
Telephone Number : 760-365-0691
Fax Number : 760-365-0692
Authorized Official
Title or Position : OWNER
Name : ELLIN M LOVELESS
Credential : BC-HIS
Telephone Number : 760-365-0691
Provider Enumeration Date : 12/05/2006
Last Update Date : 07/06/2009

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Practice Fax: 760-365-0692

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