Provider Demographics
NPI:1346607488
Name:ATTALLA, PETER
Entity Type:Individual
Prefix:
First Name:PETER
Middle Name:
Last Name:ATTALLA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23440 HAWTHORNE BLVD
Mailing Address - Street 2:SUITE 265
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4748
Mailing Address - Country:US
Mailing Address - Phone:310-375-8165
Mailing Address - Fax:
Practice Address - Street 1:1908 SANTA MONICA BLVD STE 3
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-1927
Practice Address - Country:US
Practice Address - Phone:310-846-8266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA 8034237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist