Provider Demographics
NPI:1649419250
Name:JAFARINEJAD, MIR (BUSINESS OWNER)
Entity type:Individual
Prefix:
First Name:MIR
Middle Name:
Last Name:JAFARINEJAD
Suffix:
Gender:M
Credentials:BUSINESS OWNER
Other - Prefix:
Other - First Name:HASSEN
Other - Middle Name:
Other - Last Name:GHASEMI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HEARING AID DISPENSE
Mailing Address - Street 1:7850 MISSION CENTER CT
Mailing Address - Street 2:SUITE 101-A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1322
Mailing Address - Country:US
Mailing Address - Phone:888-868-5537
Mailing Address - Fax:619-298-2376
Practice Address - Street 1:7850 MISSION CENTER CT
Practice Address - Street 2:SUITE 101-A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1322
Practice Address - Country:US
Practice Address - Phone:888-868-5537
Practice Address - Fax:619-298-2376
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-05
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA7102237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA612354399Medicare PIN