MEDICARE: DR. KAREN MARIE FAILLACE AU.D.

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	237600000X	Audiologist-Hearing Aid Fitter	AU1383	CA
2	231H00000X	Audiologist	AU1383	CA

General Provider Information

NPI Number	:	1831247600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN MARIE FAILLACE AU.D.

Provider Business Mailing Address
First Line	:	3590 CAMINO DEL RIO N STE 201
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1707
Country	:	US
Telephone Number	:	619-810-1204
Fax Number	:	619-517-3233

Provider Business Practice Location Address
First Line	:	3590 CAMINO DEL RIO N STE 201
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-1707
Country	:	US
Telephone Number	:	619-810-1204
Fax Number	:	619-517-3233

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	12/04/2024

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