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General NPI Number Information
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NPI Number | 1114287224
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Entity Type | Individual
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Provider Name | MIGUEL ANGELO AVILA AU.D.
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Gender | Male
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Dates
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Enumeration Date | 05/22/2012
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 3605 LONG BEACH BLVD STE 110
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City | LONG BEACH
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State | CA
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Zip | 90807-4023
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Country | US
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Telephone | 323-524-4523
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Fax | 562-989-8119
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Provider Business Mailing Address
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Address Line | 3605 LONG BEACH BLVD STE 110
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City | LONG BEACH
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State | CA
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Zip | 90807-4023
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Country | US
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Telephone | 323-524-4523
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Fax | 562-989-8119
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AU2824
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License Number State | CA
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