Provider Demographics
NPI:1033316625
Name:DEL MAR HEARING AID ASSOC., INC
Entity Type:Organization
Organization Name:DEL MAR HEARING AID ASSOC., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHAUNA
Authorized Official - Middle Name:DEANNE
Authorized Official - Last Name:KUBO
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS,ACA
Authorized Official - Phone:949-474-1078
Mailing Address - Street 1:24338 EL TORO RD
Mailing Address - Street 2:E-339
Mailing Address - City:LAGUNA WOODS
Mailing Address - State:CA
Mailing Address - Zip Code:92637-2776
Mailing Address - Country:US
Mailing Address - Phone:949-474-1078
Mailing Address - Fax:714-417-9651
Practice Address - Street 1:24338 EL TORO RD
Practice Address - Street 2:E-339
Practice Address - City:LAGUNA WOODS
Practice Address - State:CA
Practice Address - Zip Code:92637-2776
Practice Address - Country:US
Practice Address - Phone:949-474-1078
Practice Address - Fax:714-417-9651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2621332S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment