Provider Demographics
NPI:1619786993
Name:STASEK AUDIOLOGY, PC
Entity type:Organization
Organization Name:STASEK AUDIOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:COLE
Authorized Official - Middle Name:C
Authorized Official - Last Name:STASEK
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:586-945-6694
Mailing Address - Street 1:1045 E VALLEY PKWY
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4618
Mailing Address - Country:US
Mailing Address - Phone:760-489-6901
Mailing Address - Fax:
Practice Address - Street 1:1045 E VALLEY PKWY
Practice Address - Street 2:
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4618
Practice Address - Country:US
Practice Address - Phone:760-489-6901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-02
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty