Provider Demographics
NPI:1477512382
Name:HEAR SAN DIEGO INC
Entity Type:Organization
Organization Name:HEAR SAN DIEGO INC
Other - Org Name:SOUTH BAY HEARING AID CENTER/AMY M. BRYAN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO AND AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYAN
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:619-475-7338
Mailing Address - Street 1:125 N ACACIA AVE
Mailing Address - Street 2:STE 110
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1165
Mailing Address - Country:US
Mailing Address - Phone:619-475-7338
Mailing Address - Fax:
Practice Address - Street 1:125 N ACACIA AVE
Practice Address - Street 2:STE 110
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1165
Practice Address - Country:US
Practice Address - Phone:619-475-7338
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-20
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1983237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHA0040290OtherMEDI-CAL