Provider Demographics
NPI:1366894354
Name:SAN DIEGO HEARING AIDS, INC.
Entity type:Organization
Organization Name:SAN DIEGO HEARING AIDS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:G
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-275-0011
Mailing Address - Street 1:4504 CLAIREMONT MESA BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92117-2065
Mailing Address - Country:US
Mailing Address - Phone:619-275-0011
Mailing Address - Fax:619-275-0013
Practice Address - Street 1:4504 CLAIREMONT MESA BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92117-2065
Practice Address - Country:US
Practice Address - Phone:619-275-0011
Practice Address - Fax:619-275-0013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-01
Last Update Date:2016-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment