Healthcare Provider Details

I. General information

NPI: 1316304595
Provider Name (Legal Business Name): BALANCE & HEARING RESOURCE CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2016
Last Update Date: 01/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 W MAGNOLIA BLVD SUITE 260
BURBANK CA
91506-1753
US

IV. Provider business mailing address

2211 W MAGNOLIA BLVD SUITE 260
BURBANK CA
91506-1753
US

V. Phone/Fax

Practice location:
  • Phone: 818-859-7730
  • Fax: 818-859-7732
Mailing address:
  • Phone: 818-859-7730
  • Fax: 818-859-7732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU1440
License Number StateCA

VIII. Authorized Official

Name: MARY LYNN FRINTNER
Title or Position: PRESIDENT
Credential: AU.D.
Phone: 818-859-7730