MEDICARE: LA HEARING DIAGNOSTICS CENTERS LLC

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
2	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1518836733
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LA HEARING DIAGNOSTICS CENTERS LLC

Provider Business Mailing Address
First Line	:	2220 LYNN RD STE 202
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-8010
Country	:	US
Telephone Number	:	888-966-3277
Fax Number	:	855-826-3002

Provider Business Practice Location Address
First Line	:	2220 LYNN RD STE 202
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-8010
Country	:	US
Telephone Number	:	888-966-3277
Fax Number	:	855-826-3002

Authorized Official
Title or Position	:	PRESIDENT/CEO
Name	:	MR. WARNER GLASSFORD
Credential	:	HAD
Telephone Number	:	310-775-7795

Provider Enumeration Date	:	11/04/2025
Last Update Date	:	12/08/2025

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