Provider Demographics
NPI:1871580233
Name:HALL, GREGORY WILLIAM (MA)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:WILLIAM
Last Name:HALL
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 W SAN MARCOS BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-1116
Mailing Address - Country:US
Mailing Address - Phone:760-471-1196
Mailing Address - Fax:760-471-1550
Practice Address - Street 1:910 W SAN MARCOS BLVD
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-1115
Practice Address - Country:US
Practice Address - Phone:760-471-1196
Practice Address - Fax:760-471-1550
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU873231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAR14256Medicare UPIN
CAAUD873Medicare PIN