MEDICARE: DR. AMANDA CONRAD AUD

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	AU2850	CA

General Provider Information

NPI Number	:	1639022395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMANDA CONRAD AUD

Provider Business Mailing Address
First Line	:	6125 PRINTWOOD WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-3346
Country	:	US
Telephone Number	:	858-987-5000
Fax Number	:

Provider Business Practice Location Address
First Line	:	6125 PRINTWOOD WAY
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-3346
Country	:	US
Telephone Number	:	858-987-5000
Fax Number	:

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

Provider Enumeration Date	:	02/20/2026
Last Update Date	:	02/20/2026

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