Healthcare Provider Details

I. General information

NPI: 1851332423
Provider Name (Legal Business Name): MARIE LENORE HEPOLA MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 04/24/2023
Certification Date: 04/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20911 EARL ST STE 400
TORRANCE CA
90503-4355
US

IV. Provider business mailing address

20911 EARL ST STE 400
TORRANCE CA
90503-4355
US

V. Phone/Fax

Practice location:
  • Phone: 310-370-0007
  • Fax:
Mailing address:
  • Phone: 310-370-0007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA2535
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAU1279
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: