Provider Demographics
NPI:1043498710
Name:LIPIN, EUGENE (BC-HIS)
Entity Type:Individual
Prefix:MR
First Name:EUGENE
Middle Name:
Last Name:LIPIN
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4020 W MAGNOLIA BLVD
Mailing Address - Street 2:SUITE D
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-2828
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4020 W MAGNOLIA BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-2828
Practice Address - Country:US
Practice Address - Phone:818-848-5484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA 2248237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist