Provider Demographics
NPI:1104242981
Name:CLEAR CHOICE HEARING CLINIC INCORPORATED
Entity type:Organization
Organization Name:CLEAR CHOICE HEARING CLINIC INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SAMI
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:818-881-8877
Mailing Address - Street 1:17815 VENTURA BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1100
Mailing Address - Country:US
Mailing Address - Phone:818-881-8877
Mailing Address - Fax:818-881-8858
Practice Address - Street 1:17815 VENTURA BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-1100
Practice Address - Country:US
Practice Address - Phone:818-881-8877
Practice Address - Fax:818-881-8858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-17
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 1945237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty