Provider Demographics
NPI:1659609683
Name:ADVANCED HEARING SERVICES INC.
Entity Type:Organization
Organization Name:ADVANCED HEARING SERVICES INC.
Other - Org Name:ADVANCED HEARING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:HATZKILSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:949-250-9695
Mailing Address - Street 1:62 CORPORATE PARK
Mailing Address - Street 2:SUITE 112
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-3122
Mailing Address - Country:US
Mailing Address - Phone:949-250-9695
Mailing Address - Fax:949-250-9698
Practice Address - Street 1:62 CORPORATE PARK
Practice Address - Street 2:SUITE 112
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-3122
Practice Address - Country:US
Practice Address - Phone:949-250-9695
Practice Address - Fax:949-250-9698
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1235231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAUD1235Medicare UPIN