Provider Demographics
NPI:1912311465
Name:LIPSCHUTZ TALAMO INC
Entity Type:Organization
Organization Name:LIPSCHUTZ TALAMO INC
Other - Org Name:BERKELEY HEARING CENTER WEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUDIOLOGIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:LIPSCHUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:510-841-0681
Mailing Address - Street 1:2118 SHATTUCK AVE
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94704-1209
Mailing Address - Country:US
Mailing Address - Phone:510-841-0681
Mailing Address - Fax:510-841-0695
Practice Address - Street 1:1828 EL CAMINO REAL STE 704
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3122
Practice Address - Country:US
Practice Address - Phone:650-259-9748
Practice Address - Fax:650-697-5809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-12
Last Update Date:2016-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU1771261QH0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1689098055OtherINDIVIDUAL NPI