Provider Demographics
NPI:1255049953
Name:SHURA, PHILIP A JR (AUD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:A
Last Name:SHURA
Suffix:JR
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 1:6333 WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5702
Mailing Address - Country:US
Mailing Address - Phone:323-651-5107
Mailing Address - Fax:
Practice Address - Street 1:6333 WILSHIRE BLVD STE 309
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5723
Practice Address - Country:US
Practice Address - Phone:323-651-5107
Practice Address - Fax:323-651-4169
Is Sole Proprietor?:No
Enumeration Date:2022-11-10
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU3760237700000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist