Healthcare Provider Details

I. General information

NPI: 1427726116
Provider Name (Legal Business Name): JI-AH RYU AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2021
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3565 TORRANCE BLVD STE A
TORRANCE CA
90503-4847
US

IV. Provider business mailing address

3565 TORRANCE BLVD STE A
TORRANCE CA
90503-4847
US

V. Phone/Fax

Practice location:
  • Phone: 424-257-8285
  • Fax:
Mailing address:
  • Phone: 424-257-8285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: