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General NPI Number Information
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NPI Number | 1932646379
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Entity Type | Organization
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Legal Business Name | EVOLVE HEARING CENTER,PC
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Dates
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Enumeration Date | 01/24/2017
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Last Update Date | 01/24/2017
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Provider Practice Location Address
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Address Line | 1125 S BEVERLY DR STE 403
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City | LOS ANGELES
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State | CA
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Zip | 90035-1152
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Country | US
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Telephone | 310-277-8484
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Fax | 206-238-8659
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Provider Business Mailing Address
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Address Line | 1125 S BEVERLY DR, STE 403
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City | LOS ANGELES
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State | CA
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Zip | 90035
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Country | US
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Telephone | 310-277-8484
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Fax | 206-238-8659
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Authorized Official
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Title or Position | AUDIOLOGIST/OWNER
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Name | MS. NINA NAHMOULI
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Credential | M.A.
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Telephone | 310-277-8484
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0700X
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Taxonomy Name | Hearing and Speech Clinic/Center
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License Number | AU366
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License Number State | CA
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