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General NPI Number Information
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NPI Number | 1144599218
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Entity Type | Organization
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Legal Business Name | TAMMY PRIDA, AU.D., A PROFESSIONAL AUDIOLOGY CORPORATION
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Dates
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Enumeration Date | 12/20/2011
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Last Update Date | 05/01/2019
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Provider Practice Location Address
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Address Line | 301 W G STREET #137
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City | SAN DIEGO
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State | CA
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Zip | 92101
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Country | US
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Telephone | 619-994-1870
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Fax |
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Provider Business Mailing Address
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Address Line | 301 W G STREET #137
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City | SAN DIEGO
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State | CA
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Zip | 92101
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Country | US
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Telephone | 619-994-1870
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. TAMMY CARROLL
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Credential | AU.D.
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Telephone | 619-994-1870
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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 | AU2020
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License Number State | CA
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