Provider Demographics
NPI:1083814727
Name:SOUND BALANCE AUDIOLOGY, INC.
Entity Type:Organization
Organization Name:SOUND BALANCE AUDIOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:760-721-7417
Mailing Address - Street 1:2420 VISTA WAY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6190
Mailing Address - Country:US
Mailing Address - Phone:760-721-7417
Mailing Address - Fax:
Practice Address - Street 1:2420 VISTA WAY
Practice Address - Street 2:SUITE 205
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92054-6190
Practice Address - Country:US
Practice Address - Phone:760-721-7417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUND BALANCE AUDIOLOGY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2147231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty