Provider Demographics
NPI:1174655278
Name:COLUNGA, VICTOR TOVAR (AUD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:TOVAR
Last Name:COLUNGA
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6101 N FRESNO STREET
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710
Mailing Address - Country:US
Mailing Address - Phone:559-432-2650
Mailing Address - Fax:559-435-4618
Practice Address - Street 1:6101 N FRESNO STREET
Practice Address - Street 2:SUITE 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710
Practice Address - Country:US
Practice Address - Phone:559-432-2650
Practice Address - Fax:559-435-4618
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1523231H00000X
CAHA3371237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Not Answered237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00048503OtherRAILROAD MEDICARE
P00048503OtherRAILROAD MEDICARE