Healthcare Provider Details

I. General information

NPI: 1083814727
Provider Name (Legal Business Name): SOUND BALANCE AUDIOLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2007
Last Update Date: 07/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 VISTA WAY SUITE 205
OCEANSIDE CA
92054-6190
US

IV. Provider business mailing address

2420 VISTA WAY SUITE 205
OCEANSIDE CA
92054-6190
US

V. Phone/Fax

Practice location:
  • Phone: 760-721-7417
  • Fax:
Mailing address:
  • Phone: 760-721-7417
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU2147
License Number StateCA

VIII. Authorized Official

Name: DR. VALERIE ANN MCGUIRE
Title or Position: PRESIDENT
Credential: AU.D
Phone: 760-721-7417