Provider Demographics
NPI:1821139601
Name:PINER, BRUCE (AUD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:
Last Name:PINER
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 1:16311 VENTURA BLVD STE 841
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4397
Mailing Address - Country:US
Mailing Address - Phone:818-981-7464
Mailing Address - Fax:818-981-6328
Practice Address - Street 1:16311 VENTURA BLVD STE 841
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-4397
Practice Address - Country:US
Practice Address - Phone:818-981-7464
Practice Address - Fax:818-981-6328
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1135237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAUD1135AMedicare ID - Type UnspecifiedAUDIOLOGIST