Healthcare Provider Details

I. General information

NPI: 1760526503
Provider Name (Legal Business Name): AMERICAN HEARING AND BALANCE CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2007
Last Update Date: 11/02/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6229 W 87TH ST
LOS ANGELES CA
90045-3901
US

IV. Provider business mailing address

6229 W 87TH ST
LOS ANGELES CA
90045-3901
US

V. Phone/Fax

Practice location:
  • Phone: 310-677-1168
  • Fax: 310-377-0203
Mailing address:
  • Phone: 310-677-1168
  • Fax: 310-377-0203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAU1216
License Number StateCA

VIII. Authorized Official

Name: KEITH MICHAELS
Title or Position: OWNER
Credential: MA
Phone: 310-677-1168