Individual provider Active NPI

Miguel Angelo Avila, AU.D.

  • Audiologist
  • Long Beach, CA
National Provider Identifier
1114287224
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AU2824 Issued in CA
Practice address
3605 Long Beach Blvd Ste 110
Long Beach, CA 90807-4023
Phone
(323) 524-4523
Fax
(562) 989-8119
NPI assigned
May 22, 2012
Last updated
Jul 3, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X AU2824 CA Primary

Addresses

Primary practice location

3605 Long Beach Blvd Ste 110
Long Beach, CA 90807-4023

Mailing address

3605 Long Beach Blvd Ste 110
Long Beach, CA 90807-4023
Phone (323) 524-4523

Other practice location 1

3831 Hughes Ave.
600-B
Culver City, CA 90232-6843
Phone (310) 559-4884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140904002518 CA Practitioner - Qualified Audiologist 2668690652 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2824CAMDSurgery Physician
AU2824CAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Auditory and Vestibular Institute of Los Angeles Incorporated Audiologist Current Accepting new patients

Locations

3605 Long Beach Blvd
Ste 110
Long Beach, CA 90807
Phone (562) 427-2006

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1337644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1114287224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 LONG BEACH BLVD STE 110",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074023",
            "telephone_number": "323-524-4523",
            "fax_number": "562-989-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 LONG BEACH BLVD STE 110",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908074023",
            "telephone_number": "323-524-4523",
            "fax_number": "562-989-8119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3831 Hughes Ave.",
            "address_2": "600-B",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "902326843",
            "country_code": "US",
            "telephone_number": "310-559-4884",
            "fax_number": "310-204-3175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVILA",
        "first_name": "MIGUEL",
        "middle_name": "ANGELO",
        "name_prefix": "Dr.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-22",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU2824",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; 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.