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General NPI Number Information
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NPI Number | 1497130884
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Entity Type | Individual
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Provider Name | CARSON LYNETTE KIRSCH AU.D.
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Gender | Female
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Dates
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Enumeration Date | 07/27/2015
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Last Update Date | 11/02/2017
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Provider Practice Location Address
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Address Line | 1919 SANTA MONICA BLVD STE 220
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City | SANTA MONICA
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State | CA
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Zip | 90404-1966
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Country | US
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Telephone | 310-207-1526
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Fax |
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Provider Business Mailing Address
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Address Line | 2730 WILSHIRE BLVD STE 450
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City | SANTA MONICA
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State | CA
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Zip | 90403-4742
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Country | US
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Telephone | 310-207-1526
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Fax |
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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 | AU2113
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License Number State | CA
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