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General NPI Number Information
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NPI Number | 1477734960
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Entity Type | Individual
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Provider Name | KATHLEEN ANN BULLEY AUD
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Gender | Female
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Dates
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Enumeration Date | 11/26/2007
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 9834 GENESEE AVE STE 224
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City | LA JOLLA
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State | CA
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Zip | 92037-1223
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Country | US
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Telephone | 858-626-6394
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Fax | 858-626-6386
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Provider Business Mailing Address
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Address Line | 9834 GENESEE AVE STE 224
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City | LA JOLLA
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State | CA
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Zip | 92037-1223
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Country | US
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Telephone | 858-626-6394
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Fax | 858-626-6386
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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 | AU839
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License Number State | CA
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