Healthcare Provider Details

I. General information

NPI: 1942084306
Provider Name (Legal Business Name): SARAH HOSTETLER AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2023
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3044 HORACE ST
RIVERSIDE CA
92506-4420
US

IV. Provider business mailing address

7280 EL DORADO DR
BUENA PARK CA
90620-2549
US

V. Phone/Fax

Practice location:
  • Phone: 951-248-7700
  • Fax:
Mailing address:
  • Phone: 714-403-7968
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3641
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: