Healthcare Provider Details

I. General information

NPI: 1720673791
Provider Name (Legal Business Name): PERFORMANCE HEARING CENTER, A PROF. AUDIOLOGY CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2021
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21201 VICTORY BLVD STE 115
CANOGA PARK CA
91303-2830
US

IV. Provider business mailing address

21201 VICTORY BLVD STE 115
CANOGA PARK CA
91303-2830
US

V. Phone/Fax

Practice location:
  • Phone: 818-914-5077
  • Fax:
Mailing address:
  • Phone: 818-914-5077
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State

VIII. Authorized Official

Name: BEVERLY D'CUNHA
Title or Position: AUDIOLOGIST
Credential:
Phone: 818-614-1770