Healthcare Provider Details

I. General information

NPI: 1407211899
Provider Name (Legal Business Name): ASHLEY E BAHR AU.D., CCC-A, CNIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2015
Last Update Date: 01/09/2021
Certification Date: 01/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2815 CAMINO DEL RIO S STE 220
SAN DIEGO CA
92108-3817
US

IV. Provider business mailing address

2815 CAMINO DEL RIO S STE 220
SAN DIEGO CA
92108-3817
US

V. Phone/Fax

Practice location:
  • Phone: 858-279-6772
  • Fax:
Mailing address:
  • Phone: 515-505-8242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number073592
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number073593
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3474
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: