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General NPI Number Information
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NPI Number | 1669603205
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Entity Type | Organization
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Legal Business Name | LEO SOO HOO, M.A., INC.
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Dates
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Enumeration Date | 07/30/2009
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Last Update Date | 07/30/2009
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Provider Practice Location Address
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Address Line | 4760 S. PECOS ROAD SUITE 103-27
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City | LAS VEGAS
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State | NV
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Zip | 89121
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Country | US
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Telephone | 702-369-9706
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Fax |
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Provider Business Mailing Address
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Address Line | 9244 EVERGREEN CANYON DRIVE
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City | LAS VEGAS
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State | NV
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Zip | 89134
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Country | US
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Telephone | 702-363-8460
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/AUDIOLOGIST
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Name | LEO SOO HOO JR.
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Credential | M.A.
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Telephone | 702-369-9706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | HAS238
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A-113
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License Number State | NV
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