Healthcare Provider Details
I. General information
NPI: 1124827720
Provider Name (Legal Business Name): BREITLING AUDIOLOGY GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/07/2025
Last Update Date: 03/07/2025
Certification Date: 03/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3744 MT DIABLO BLVD STE 100
LAFAYETTE CA
94549-3661
US
IV. Provider business mailing address
3744 MT DIABLO BLVD STE 100
LAFAYETTE CA
94549-3661
US
V. Phone/Fax
- Phone: 925-262-4242
- Fax: 925-262-4255
- Phone: 925-262-4242
- Fax: 925-262-4255
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 237600000X |
| Taxonomy | Audiologist-Hearing Aid Fitter |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 231H00000X |
| Taxonomy | Audiologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ERIK
MARTIN
BREITLING
Title or Position: CEO
Credential: AU.D.
Phone: 925-262-4230