Healthcare Provider Details

I. General information

NPI: 1427301340
Provider Name (Legal Business Name): LINDSAY LIVENGOOD AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2012
Last Update Date: 01/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 KUALA ST SUITE #104
PEARL CITY HI
96782-3900
US

IV. Provider business mailing address

1245 KUALA ST SUITE #104
PEARL CITY HI
96782-3900
US

V. Phone/Fax

Practice location:
  • Phone: 808-206-7508
  • Fax: 808-484-4133
Mailing address:
  • Phone: 808-206-7508
  • Fax: 808-484-4133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD144
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAU2864
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberHA244
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: