Provider Demographics
NPI:1508090168
Name:ADVANCED HEARING, INC
Entity Type:Organization
Organization Name:ADVANCED HEARING, INC
Other - Org Name:ADVANCED HEARING CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:AA
Authorized Official - Phone:707-291-2448
Mailing Address - Street 1:2360 MENDOCINO AVE # A2-106
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-3153
Mailing Address - Country:US
Mailing Address - Phone:707-291-2448
Mailing Address - Fax:
Practice Address - Street 1:3850 E SUNSET RD STE F
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89120-4913
Practice Address - Country:US
Practice Address - Phone:702-873-1589
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVHAS153237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty