Provider Demographics
NPI:1548584949
Name:TUSTIN AUDIOLOGY, INC.
Entity Type:Organization
Organization Name:TUSTIN AUDIOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-731-6549
Mailing Address - Street 1:12791 NEWPORT AVENUE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-2785
Mailing Address - Country:US
Mailing Address - Phone:714-731-6549
Mailing Address - Fax:714-730-5372
Practice Address - Street 1:12791 NEWPORT AVENUE
Practice Address - Street 2:SUITE 101
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2785
Practice Address - Country:US
Practice Address - Phone:714-731-6549
Practice Address - Fax:714-730-5372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-15
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty