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NPI Code Detail

MEDICARE: AMERICAN HEARING AND BALANCE CORPORATION

MEDICARE: AMERICAN HEARING AND BALANCE CORPORATION
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
1237600000XAudiologist-Hearing Aid FitterAU1216CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
24309846OTHERCAAETNA PROVIDER NUMBER

General Provider Information

NPI Number : 1760526503
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMERICAN HEARING AND BALANCE CORPORATION
Provider Business Mailing Address
First Line : 6229 W 87TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-3901
Country : US
Telephone Number : 310-677-1168
Fax Number : 310-377-0203
Provider Business Practice Location Address
First Line : 6229 W 87TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-3901
Country : US
Telephone Number : 310-677-1168
Fax Number : 310-377-0203
Authorized Official
Title or Position : OWNER
Name : KEITH MICHAELS
Credential : MA
Telephone Number : 310-677-1168
Provider Enumeration Date : 02/16/2007
Last Update Date : 11/02/2007

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6229 W 87TH ST
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1720122450 — DR. KEITH P MICHAELS AUD
Practice Location Address:
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1144403551 — ELISSA VALENTINO
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Practice Location Address:
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Practice Fax: 310-677-0203

Directions to “AMERICAN HEARING AND BALANCE CORPORATION ” Practice Location

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