Provider Demographics
NPI:1043365034
Name:HEARING AID CENTER OF THE SAN JOAQUIN VALLEY INC.
Entity Type:Organization
Organization Name:HEARING AID CENTER OF THE SAN JOAQUIN VALLEY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:HALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-225-2211
Mailing Address - Street 1:8812 N 10TH ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-1869
Mailing Address - Country:US
Mailing Address - Phone:559-225-2211
Mailing Address - Fax:559-225-3928
Practice Address - Street 1:4836 N 1ST ST
Practice Address - Street 2:#102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-0527
Practice Address - Country:US
Practice Address - Phone:559-225-2211
Practice Address - Fax:559-225-3928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-23
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA2195237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty