Healthcare Provider Details

I. General information

NPI: 1063294510
Provider Name (Legal Business Name): JACOB HOHSFIELD AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2023
Last Update Date: 10/19/2023
Certification Date: 10/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11645 WILSHIRE BLVD # 601B
LOS ANGELES CA
90025-1708
US

IV. Provider business mailing address

1836 N NEW HAMPSHIRE AVE APT 109
LOS ANGELES CA
90027-4264
US

V. Phone/Fax

Practice location:
  • Phone: 310-909-0180
  • Fax:
Mailing address:
  • Phone: 209-329-2427
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3840
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: