MEDICARE: LINGUAL TREE, INC

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	261QH0700X	Hearing and Speech Clinic/Center		CA

General Provider Information

NPI Number	:	1790294387
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LINGUAL TREE, INC

Provider Business Mailing Address
First Line	:	1641 VETERAN AVE APT 7
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-5581
Country	:	US
Telephone Number	:	310-975-9211
Fax Number	:

Provider Business Practice Location Address
First Line	:	1641 VETERAN AVE APT 7
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-5581
Country	:	US
Telephone Number	:	310-975-9211
Fax Number	:

Authorized Official
Title or Position	:	SPEECH-LANGUAGE PATHOLOGIST
Name	:	YIRMYAHO ZUBERY
Credential	:	M.S.
Telephone Number	:	310-975-9211

Provider Enumeration Date	:	09/26/2017
Last Update Date	:	07/21/2022

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