Provider Demographics
NPI:1831463082
Name:WILLOW LINK LLC
Entity Type:Organization
Organization Name:WILLOW LINK LLC
Other - Org Name:SOUNDWELL HEARING AIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:GISANG
Authorized Official - Middle Name:
Authorized Official - Last Name:RYU
Authorized Official - Suffix:
Authorized Official - Credentials:HIS
Authorized Official - Phone:949-398-7315
Mailing Address - Street 1:14795 JEFFREY RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-0414
Mailing Address - Country:US
Mailing Address - Phone:949-398-7315
Mailing Address - Fax:949-398-7314
Practice Address - Street 1:14795 JEFFREY RD
Practice Address - Street 2:SUITE 202
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-0414
Practice Address - Country:US
Practice Address - Phone:949-398-7315
Practice Address - Fax:949-398-7314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-06
Last Update Date:2012-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA7668237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty