Healthcare Provider Details

I. General information

NPI: 1003944877
Provider Name (Legal Business Name): HOUSE EAR INSTITUTE CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 W 3RD ST
LOS ANGELES CA
90057-1922
US

IV. Provider business mailing address

2100 W 3RD ST
LOS ANGELES CA
90057-1922
US

V. Phone/Fax

Practice location:
  • Phone: 213-353-7005
  • Fax: 213-483-3716
Mailing address:
  • Phone: 213-353-7005
  • Fax: 213-483-3716

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU1052
License Number StateCA

VIII. Authorized Official

Name: JANICE ELLEN LOGGINS
Title or Position: SENIOR AUDIOLOGIST
Credential: M.A., CCC-A, FAAA
Phone: 213-353-7005