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General NPI Number Information
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NPI Number | 1023062510
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Entity Type | Individual
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Provider Name | KEVIN G BOLDER AU.D.
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Gender | Male
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 25425 ORCHARD VILLAGE RD STE 220
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City | SANTA CLARITA
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State | CA
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Zip | 91355-2959
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Country | US
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Telephone | 661-284-1900
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Fax | 661-284-1988
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Provider Business Mailing Address
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Address Line | 25425 ORCHARD VILLAGE RD STE 220
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City | SANTA CLARITA
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State | CA
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Zip | 91355-2959
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Country | US
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Telephone | 661-284-1900
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Fax | 661-284-1988
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | AU1957
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License Number State | CA
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