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General NPI Number Information
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NPI Number | 1841792041
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Entity Type | Organization
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Legal Business Name | SHANNON MYERS AUD CNIM A PROFESSIONAL AUDIOLOGY CORPORATION
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Dates
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Enumeration Date | 03/02/2018
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 2955 VANCOUVER AVE
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City | SAN DIEGO
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State | CA
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Zip | 92104-4830
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Country | US
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Telephone | 215-720-6183
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Fax |
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Provider Business Mailing Address
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Address Line | 2955 VANCOUVER AVE
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City | SAN DIEGO
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State | CA
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Zip | 92104-4830
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Country | US
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Telephone | 215-720-6183
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Fax | 619-924-4191
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Authorized Official
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Title or Position | PRESIDENT
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Name | SHANNON MYERS
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Credential | AUD CNIM
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Telephone | 215-720-6183
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 246ZE0600X
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Taxonomy Name | Electroneurodiagnostic Specialist/Technologist
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License Number |
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License Number State |
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