Healthcare Provider Details

I. General information

NPI: 1821139601
Provider Name (Legal Business Name): BRUCE PINER AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 03/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16311 VENTURA BLVD STE 841
ENCINO CA
91436-4397
US

IV. Provider business mailing address

16311 VENTURA BLVD STE 841
ENCINO CA
91436-4397
US

V. Phone/Fax

Practice location:
  • Phone: 818-981-7464
  • Fax: 818-981-6328
Mailing address:
  • Phone: 818-981-7464
  • Fax: 818-981-6328

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAU1135
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: