Provider Demographics
NPI:1033653738
Name:NORTH COAST AUDIOLOGY
Entity Type:Organization
Organization Name:NORTH COAST AUDIOLOGY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/AUDIOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:NESBITT
Authorized Official - Suffix:
Authorized Official - Credentials:SCD, FAAA
Authorized Official - Phone:760-452-2140
Mailing Address - Street 1:4407 MANCHESTER AVE
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-4900
Mailing Address - Country:US
Mailing Address - Phone:760-452-2140
Mailing Address - Fax:760-452-2142
Practice Address - Street 1:4407 MANCHESTER AVE
Practice Address - Street 2:SUITE 108
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-4900
Practice Address - Country:US
Practice Address - Phone:760-452-2140
Practice Address - Fax:760-452-2142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2613231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty