Healthcare Provider Details

I. General information

NPI: 1568763068
Provider Name (Legal Business Name): ALL EARS AUDIOLOGY, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2010
Last Update Date: 11/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 W LA VETA AVE STE 201
ORANGE CA
92866-2607
US

IV. Provider business mailing address

1116 E CARLETON AVE
ORANGE CA
92867-3868
US

V. Phone/Fax

Practice location:
  • Phone: 714-927-7888
  • Fax:
Mailing address:
  • Phone: 714-927-7888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAU1805
License Number StateCA

VIII. Authorized Official

Name: ROSALIE HUYNH
Title or Position: PRESIDENT
Credential: AUD
Phone: 714-927-7888