Healthcare Provider Details

I. General information

NPI: 1619786993
Provider Name (Legal Business Name): STASEK AUDIOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2025
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1045 E VALLEY PKWY
ESCONDIDO CA
92025-4618
US

IV. Provider business mailing address

1045 E VALLEY PKWY
ESCONDIDO CA
92025-4618
US

V. Phone/Fax

Practice location:
  • Phone: 760-489-6901
  • Fax:
Mailing address:
  • Phone: 760-489-6901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: DR. COLE C STASEK
Title or Position: PRESIDENT
Credential: AU.D.
Phone: 586-945-6694