Healthcare Provider Details

I. General information

NPI: 1154858017
Provider Name (Legal Business Name): DANIEL LEDEE AU.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 07/21/2022
Certification Date: 04/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5405 OBERLIN DR FL 2
SAN DIEGO CA
92121-1700
US

IV. Provider business mailing address

5405 OBERLIN DR FL 2
SAN DIEGO CA
92121-1700
US

V. Phone/Fax

Practice location:
  • Phone: 858-909-0770
  • Fax: 858-909-0880
Mailing address:
  • Phone: 858-909-0770
  • Fax: 858-909-0880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA-2113
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberA-2113
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberA-2113
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: