MEDICARE: MRS. ALLISON ROBERTS AU.D.

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	231H00000X	Audiologist	AU 2905	CA

General Provider Information

NPI Number	:	1427497460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALLISON ROBERTS AU.D.

Provider Business Mailing Address
First Line	:	5220 CLARK AVENUE
Second Line	:	SUITE 100
City	:	LAKEWOOD
State	:	CA
Zip	:	90712
Country	:	US
Telephone Number	:	562-439-9539
Fax Number	:	562-439-2232

Provider Business Practice Location Address
First Line	:	5842 E NAPLES PLZ
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-5039
Country	:	US
Telephone Number	:	562-439-9539
Fax Number	:	562-439-2232

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2013
Last Update Date	:	03/20/2019

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