Active NPI
Ehsan Jason Kamalvand
- Hearing Instrument Specialist
- Orange, CA
National Provider Identifier
1043472533
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hearing Instrument Specialist
- License
- HA6014
- Practice address
- 1635 E Lincoln Ave
Orange, CA 92865-1929 - Phone
- (714) 282-9911
- Fax
- (714) 282-9811
- NPI assigned
- Jun 26, 2008
- Reactivated
- Oct 31, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hearing Instrument Specialist | 237700000X | HA6014 | CA | Primary |
Addresses
Primary practice location
1635 E Lincoln Ave
Orange, CA 92865-1929
Mailing address
260 Main St
Ste F
Redwood City, CA 94063-1778
Phone (650) 366-2900
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HA6014 | CA | MD | Hearing Instrument Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Hearing Inc. | Hearing Instrument Specialist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Hearing Instrument Specialist
- Orange, CA
- NPI 1114107505
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1540944000000",
"number": "1043472533",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "260 MAIN ST",
"address_2": "STE F",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940631778",
"telephone_number": "650-366-2900",
"fax_number": "650-366-2908"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1635 E LINCOLN AVE",
"city": "ORANGE",
"state": "CA",
"postal_code": "928651929",
"telephone_number": "714-282-9911",
"fax_number": "714-282-9811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAMALVAND",
"first_name": "EHSAN",
"middle_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-26",
"last_updated": "2018-10-31",
"deactivation_date": "2018-01-25",
"reactivation_date": "2018-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "237700000X",
"taxonomy_group": "",
"desc": "Hearing Instrument Specialist",
"state": "CA",
"license": "HA6014",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.