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General NPI Number Information
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NPI Number | 1538105507
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Entity Type | Individual
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Provider Name | LAUREN ANNE BOSCH M.A.
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Gender | Female
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3350 LA JOLLA VILLAGE DR SUITE 126
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City | LA JOLLA
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State | CA
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Zip | 92037-1806
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Country | US
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Telephone | 858-552-7564
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Fax |
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Provider Business Mailing Address
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Address Line | 6655 LA JOLLA BLVD #21
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City | LA JOLLA
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State | CA
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Zip | 92037-0003
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Country | US
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Telephone | 858-336-6601
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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 | AU2219
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License Number State | CA
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