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General NPI Number Information
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NPI Number | 1790522712
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Entity Type | Individual
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Provider Name | ZACHARY WALTER ABT AUD
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Gender | Male
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Dates
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Enumeration Date | 07/09/2024
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 960 E GREEN ST STE 208
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City | PASADENA
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State | CA
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Zip | 91106-2401
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Country | US
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Telephone | 424-314-0196
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Fax |
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Provider Business Mailing Address
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Address Line | 4140 W 190TH ST
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City | TORRANCE
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State | CA
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Zip | 90504-5513
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Country | US
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Telephone | 424-314-0196
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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 | AU3916
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License Number State | CA
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