Provider Demographics
NPI:1407148166
Name:AUDIOLOGY & HEARING AID CONSULTANTS INC.
Entity Type:Organization
Organization Name:AUDIOLOGY & HEARING AID CONSULTANTS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF AUDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
Authorized Official - Last Name:GODINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:818-783-0322
Mailing Address - Street 1:4910 VAN NUYS BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-1879
Mailing Address - Country:US
Mailing Address - Phone:818-783-0322
Mailing Address - Fax:818-783-0323
Practice Address - Street 1:4910 VAN NUYS BLVD STE 201
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1879
Practice Address - Country:US
Practice Address - Phone:818-783-0322
Practice Address - Fax:818-783-0323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-12
Last Update Date:2014-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2267237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU0022670Medicaid
CADJ738AMedicare PIN