Healthcare Provider Details

I. General information

NPI: 1316948557
Provider Name (Legal Business Name): PRISCILLA HAYFIELD GEORGE AU
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL CAMP PENDLETON BLDG H100 SANTA MARGARITA, ATTEN: CODE CS-PA
CAMP PENDLETON CA
92055
US

IV. Provider business mailing address

811 VALLEY AVE
SOLANA BEACH CA
92075-2432
US

V. Phone/Fax

Practice location:
  • Phone: 760-725-1644
  • Fax: 760-725-1563
Mailing address:
  • Phone: 858-259-1274
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU 970
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: