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General NPI Number Information
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NPI Number | 1023569191
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Entity Type | Organization
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Legal Business Name | TRINITY AZEVEDO BLITT, INC
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Dates
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Enumeration Date | 10/24/2016
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Last Update Date | 03/02/2017
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Provider Practice Location Address
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Address Line | 6037 LA GRANADA SUITE D
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City | RANCHO SANTA FE
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State | CA
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Zip | 92067
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Country | US
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Telephone | 858-759-8922
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Fax |
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Provider Business Mailing Address
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Address Line | 1501 FRONT ST UNIT 302
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City | SAN DIEGO
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State | CA
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Zip | 92101-2973
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Country | US
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Telephone | 209-756-8456
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Fax |
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Authorized Official
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Title or Position | OWNER/AUDIOLOGIST
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Name | DR. TRINITY AZEVEDO BLITT
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Credential | AU.D.
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Telephone | 209-756-8456
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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 | AU 3077
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License Number State | CA
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