Healthcare Provider Details

I. General information

NPI: 1790778884
Provider Name (Legal Business Name): ELIZABETH COMER JARAMILLO AU.D, CNIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: POLLY ELIZABETH AMARAL AU.D, CNIM

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 01/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10755 SCRIPPS POWAY PKWY STE 581
SAN DIEGO CA
92131-3924
US

IV. Provider business mailing address

10755 SCRIPPS POWAY PKWY STE 581
SAN DIEGO CA
92131-3924
US

V. Phone/Fax

Practice location:
  • Phone: 858-433-7626
  • Fax: 877-240-8624
Mailing address:
  • Phone: 858-433-7626
  • Fax: 877-240-8624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: