Healthcare Provider Details

I. General information

NPI: 1518836733
Provider Name (Legal Business Name): LA HEARING DIAGNOSTICS CENTERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2220 LYNN RD STE 202
THOUSAND OAKS CA
91360-8010
US

IV. Provider business mailing address

2220 LYNN RD STE 202
THOUSAND OAKS CA
91360-8010
US

V. Phone/Fax

Practice location:
  • Phone: 888-966-3277
  • Fax: 855-826-3002
Mailing address:
  • Phone: 888-966-3277
  • Fax: 855-826-3002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name: MR. WARNER GLASSFORD
Title or Position: PRESIDENT/CEO
Credential: HAD
Phone: 310-775-7795