Healthcare Provider Details

I. General information

NPI: 1073754230
Provider Name (Legal Business Name): HEARING AID SERVICES OF HOLLYWOOD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2009
Last Update Date: 05/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7080 HOLLYWOOD BLVD SUITE 814
LOS ANGELES CA
90028-6935
US

IV. Provider business mailing address

7080 HOLLYWOOD BLVD SUITE 814
LOS ANGELES CA
90028-6935
US

V. Phone/Fax

Practice location:
  • Phone: 323-463-7109
  • Fax: 323-463-7707
Mailing address:
  • Phone: 323-463-7109
  • Fax: 323-463-7707

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU 362
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberHA 1056
License Number StateCA

VIII. Authorized Official

Name: JOHN JEFFREY GRAMA
Title or Position: PRESIDENT
Credential: M.A.
Phone: 323-463-7109