Healthcare Provider Details

I. General information

NPI: 1265652770
Provider Name (Legal Business Name): SOUTH BAY HEARING & BALANCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

453 4TH AVE
CHULA VISTA CA
91910-4405
US

IV. Provider business mailing address

453 4TH AVE
CHULA VISTA CA
91910-4405
US

V. Phone/Fax

Practice location:
  • Phone: 619-427-9900
  • Fax: 619-427-9909
Mailing address:
  • Phone: 619-427-9900
  • Fax: 619-427-9909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU1566
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code231HA2500X
TaxonomyAssistive Technology Supplier Audiologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: GARY A COTE
Title or Position: OWNER
Credential: MA
Phone: 619-427-9900