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General NPI Number Information
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NPI Number | 1801044698
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Entity Type | Organization
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Legal Business Name | LOS ANGELES AUDIOLOGY GROUP, INC.
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Dates
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Enumeration Date | 09/04/2008
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Last Update Date | 09/04/2008
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Provider Practice Location Address
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Address Line | 3875 WILSHIRE BLVD SUITE 302
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City | LOS ANGELES
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State | CA
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Zip | 90010-3205
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Country | US
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Telephone | 213-386-6108
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Fax | 213-386-6182
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Provider Business Mailing Address
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Address Line | 3875 WILSHIRE BLVD SUITE 302
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City | LOS ANGELES
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State | CA
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Zip | 90010-3205
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Country | US
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Telephone | 213-386-6108
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Fax | 213-386-6182
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Authorized Official
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Title or Position | PRESIDENT
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Name | MATTHEW DENZIL MICHAELS
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Credential | M.S.
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Telephone | 213-386-6108
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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 | AU1730
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License Number State | CA
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