MEDICARE: LAURA CECILE ACKERMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	HA4190	CA
2	237600000X	Audiologist-Hearing Aid Fitter	AU2170	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144277690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA CECILE ACKERMAN

Provider Business Mailing Address
First Line	:	5000 CHESHIRE PKWY N
Second Line	:
City	:	PLYMOUTH
State	:	MN
Zip	:	55446-4103
Country	:	US
Telephone Number	:	763-268-4115
Fax Number	:	763-268-4430

Provider Business Practice Location Address
First Line	:	11600 WILSHIRE BLVD
Second Line	:	STE 114
City	:	LOS ANGELES
State	:	CA
Zip	:	90025-5781
Country	:	US
Telephone Number	:	310-477-1519
Fax Number	:	310-479-5673

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	01/25/2011

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Directions to “ LAURA CECILE ACKERMAN ” Practice Location

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