Provider Demographics
NPI:1194823054
Name:GOSALIA, AMIT K (AUD)
Entity Type:Individual
Prefix:DR
First Name:AMIT
Middle Name:K
Last Name:GOSALIA
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 1:21731 VENTURA BLVD STE 165
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-5110
Mailing Address - Country:US
Mailing Address - Phone:818-222-9451
Mailing Address - Fax:
Practice Address - Street 1:21731 VENTURA BLVD STE 165
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-5110
Practice Address - Country:US
Practice Address - Phone:818-222-9451
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD60042114231H00000X, 237600000X
CA3208231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8526774Medicaid
WA8526774Medicaid