Provider Demographics
NPI:1821596693
Name:RJHHACTIVEHEARINGINC
Entity Type:Organization
Organization Name:RJHHACTIVEHEARINGINC
Other - Org Name:ACTIVE HEARING AID CENTER HEARING AID STORE SONUS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EHSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMALVAND
Authorized Official - Suffix:
Authorized Official - Credentials:HEARING AID DISPNSER
Authorized Official - Phone:770-934-6627
Mailing Address - Street 1:260 MAIN ST STE F
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94063-1733
Mailing Address - Country:US
Mailing Address - Phone:770-527-5223
Mailing Address - Fax:
Practice Address - Street 1:260 MAIN ST STE F
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-1733
Practice Address - Country:US
Practice Address - Phone:770-527-5223
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA6014237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty