Provider Demographics
NPI:1730927625
Name:THE AUDITORY AND VESTIBULAR INSTITUE OF LOS ANGELES
Entity type:Organization
Organization Name:THE AUDITORY AND VESTIBULAR INSTITUE OF LOS ANGELES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:ANGELO
Authorized Official - Last Name:AVILA
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:323-524-3399
Mailing Address - Street 1:3605 LONG BEACH BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-4023
Mailing Address - Country:US
Mailing Address - Phone:323-524-3399
Mailing Address - Fax:562-989-8119
Practice Address - Street 1:3605 LONG BEACH BLVD STE 110
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4023
Practice Address - Country:US
Practice Address - Phone:323-524-3399
Practice Address - Fax:562-989-8119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-16
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Multi-Specialty
No231HA2500XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology SupplierGroup - Multi-Specialty
No2355A2700XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistAudiology AssistantGroup - Multi-Specialty