1649419250 NPI number — MIR JAFARINEJAD BUSINESS OWNER

Table of content: MIR JAFARINEJAD BUSINESS OWNER (NPI 1649419250)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649419250 NPI number — MIR JAFARINEJAD BUSINESS OWNER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JAFARINEJAD
Provider First Name:
MIR
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
BUSINESS OWNER
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GHASEMI
Provider Other First Name:
HASSEN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
HEARING AID DISPENSE
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1649419250
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/05/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7850 MISSION CENTER CT
Provider Second Line Business Mailing Address:
SUITE 101-A
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92108-1322
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
888-868-5537
Provider Business Mailing Address Fax Number:
619-298-2376

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7850 MISSION CENTER CT
Provider Second Line Business Practice Location Address:
SUITE 101-A
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92108-1322
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-868-5537
Provider Business Practice Location Address Fax Number:
619-298-2376
Provider Enumeration Date:
02/05/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 237700000X , with the licence number:  HA7102 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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