Provider Demographics
NPI:1881611606
Name:NOBLE AUDIOLOGY, A PROFESSIONAL CORP
Entity type:Organization
Organization Name:NOBLE AUDIOLOGY, A PROFESSIONAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER AUDIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:LESLIE
Authorized Official - Last Name:NOBLE
Authorized Official - Suffix:
Authorized Official - Credentials:AUD, MS, CCC A
Authorized Official - Phone:714-842-2700
Mailing Address - Street 1:7106 EDINGER AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-3568
Mailing Address - Country:US
Mailing Address - Phone:714-842-2700
Mailing Address - Fax:714-842-2712
Practice Address - Street 1:7106 EDINGER AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-3568
Practice Address - Country:US
Practice Address - Phone:714-842-2700
Practice Address - Fax:714-842-2712
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2008-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU823237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAUD823Medicare ID - Type Unspecified