Pacific Coast Audiology, Inc.

Primary specialty

AudiologistTaxonomy code 231H00000X

Legal business name

PACIFIC COAST AUDIOLOGY, INC.

Practice address

1035 Peach St Ste 204
San Luis Obispo, CA 93401-2700

Phone

(805) 476-6212

Fax

(805) 269-8091

NPI assigned

Dec 15, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Ryan Kennard, AU.D.NPI 1023425337

Title

Audiologist

Phone

(805) 476-6212

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ryan Kennard, AU.D.

  • Audiologist
  • San Luis Obispo, CA
  • NPI 1023425337
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1063124527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 PEACH ST STE 204",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012700",
            "telephone_number": "805-476-6212",
            "fax_number": "805-269-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 PEACH ST STE 204",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012700",
            "telephone_number": "805-476-6212",
            "fax_number": "805-269-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC COAST AUDIOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-15",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "KENNARD",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "AUDIOLOGIST",
        "authorized_official_telephone_number": "805-476-6212",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "AU.D."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pacific Central Coast Health Centers (Mission Hope Medical Oncology - San Luis Obispo)
• Pacific Central Coast Health Centers (Bishop's Peak Women's Health Center)
• Pacific Central Coast Health Centers (Aerovista Health Center)
• Pacific Central Coast Health Centers (Medical Clinic at Peach - North)
• Pacific Central Coast Health Centers (Coastal Cardiology - San Luis Obispo II)
• Pacific Coast Physicians Medical Group
• Pacific Eye Surgeons, a California Professional Medical Corporation
• Pacific Medical, Inc.
• Pacific Pediatric Dentistry
• Pacific Point Laboratories, Inc.

• Audiologist in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Audiologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.