Provider Demographics
NPI:1093091662
Name:AMERICAN HEARING AID CENTER OF THE SOUTH BAY, INC
Entity Type:Organization
Organization Name:AMERICAN HEARING AID CENTER OF THE SOUTH BAY, INC
Other - Org Name:SONUS SF0024
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:DANDURAND
Authorized Official - Suffix:
Authorized Official - Credentials:BC-HIS
Authorized Official - Phone:310-989-3092
Mailing Address - Street 1:13820 DONNYBROOK LN
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-2827
Mailing Address - Country:US
Mailing Address - Phone:310-989-3092
Mailing Address - Fax:805-530-3989
Practice Address - Street 1:9340 CLAIREMONT MESA BLVD
Practice Address - Street 2:STE D
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1224
Practice Address - Country:US
Practice Address - Phone:858-278-9911
Practice Address - Fax:858-565-7324
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN HEARING AID CENTER OF THE SOUTH BAY, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-10-27
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA 2056237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty