MEDICARE: MRS. CRIS TEENA HUNT AUDIOLOGIST

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	AU1572	CA

General Provider Information

NPI Number	:	1659883122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CRIS TEENA HUNT AUDIOLOGIST

Provider Business Mailing Address
First Line	:	4705 DEL MONTE AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92107-3501
Country	:	US
Telephone Number	:	619-316-6001
Fax Number	:	619-316-6001

Provider Business Practice Location Address
First Line	:	4705 DEL MONTE AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92107-3501
Country	:	US
Telephone Number	:	619-316-6001
Fax Number	:

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

Provider Enumeration Date	:	10/24/2017
Last Update Date	:	10/24/2017

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