MEDICARE: AUDIUVA, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	237700000X	Hearing Instrument Specialist	HA7013	CA

General Provider Information

NPI Number	:	1275924748
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AUDIUVA, INC.

Provider Business Mailing Address
First Line	:	3943 COUNTRY CLUB DR
Second Line	:
City	:	LAKEWOOD
State	:	CA
Zip	:	90712-3827
Country	:	US
Telephone Number	:	714-476-2996
Fax Number	:

Provider Business Practice Location Address
First Line	:	2908 WESTMINSTER AVE
Second Line	:
City	:	SEAL BEACH
State	:	CA
Zip	:	90740-5305
Country	:	US
Telephone Number	:	562-794-1981
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RANDALL ROMBERG
Credential	:
Telephone Number	:	562-794-1981

Provider Enumeration Date	:	02/05/2015
Last Update Date	:	02/05/2015

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