Healthcare Provider Details

I. General information

NPI: 1982827010
Provider Name (Legal Business Name): ROBERT JOSEPH DUSA JR. M.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8933 ACTIVITY RD
SAN DIEGO CA
92126-4427
US

IV. Provider business mailing address

8933 ACTIVITY RD
SAN DIEGO CA
92126-4427
US

V. Phone/Fax

Practice location:
  • Phone: 858-653-6136
  • Fax:
Mailing address:
  • Phone: 858-653-6136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU 1647
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code231HA2400X
TaxonomyAssistive Technology Practitioner Audiologist
License NumberAU 1647
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: