Healthcare Provider Details

I. General information

NPI: 1891972113
Provider Name (Legal Business Name): SOUTH BAY HEARING & BALANCE CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 04/02/2025
Certification Date: 04/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3734 SEPULVEDA BLVD
TORRANCE CA
90505-2513
US

IV. Provider business mailing address

3734 SEPULVEDA BLVD
TORRANCE CA
90505-2513
US

V. Phone/Fax

Practice location:
  • Phone: 310-375-6161
  • Fax: 310-375-6101
Mailing address:
  • Phone: 310-375-6161
  • Fax: 310-375-6101

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU645
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code235500000X
TaxonomySpeech/Language/Hearing Specialist/Technologist
License NumberAU645
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAU645
License Number StateCA

VIII. Authorized Official

Name: IAN GERSZEWSKI
Title or Position: OWNER
Credential: AUD
Phone: 310-325-5004