Active NPI
Pacific Hearing & Balance, Inc.
- Specialist
- Marina del Rey, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- W15955A
- Legal business name
- PACIFIC HEARING & BALANCE, INC.
- Practice address
- 4644 Lincoln Blvd
Suite # 409
Marina del Rey, CA 90292-6313 - Phone
- (310) 574-1116
- NPI assigned
- Jun 26, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gregory James Frazer, AU.D., PH.D.
- Title
- President
- Phone
- (310) 477-7281
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | W15955A | CA | Primary |
Addresses
Primary practice location
4644 Lincoln Blvd
Suite # 409
Marina del Rey, CA 90292-6313
Mailing address
4644 Lincoln Blvd
Suite # 409
Marina del Rey, CA 90292-6313
Phone (310) 574-1116
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GAU000793 | Medicaid | CA |
National Provider Directory
National Provider Directory- Tax ID family
- Pacific Hearing
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Specialist
- Los Angeles, CA
- NPI 1831137223
Locations
11645 Wilshire Blvd
#601B
Los Angeles, CA 90025
Phone (310) 477-5558
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1386670602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4644 LINCOLN BLVD",
"address_2": "SUITE # 409",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902926313",
"telephone_number": "310-574-1116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4644 LINCOLN BLVD",
"address_2": "SUITE # 409",
"city": "MARINA DEL REY",
"state": "CA",
"postal_code": "902926313",
"telephone_number": "310-574-1116"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PACIFIC HEARING & BALANCE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-26",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "FRAZER",
"authorized_official_first_name": "GREGORY",
"authorized_official_middle_name": "JAMES",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "310-477-7281",
"authorized_official_credential": "AU.D., PH.D."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "CA",
"license": "W15955A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GAU000793",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marina del Rey, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.