Organization Active NPI

Pacific Hearing , Inc

  • Specialist
  • Los Angeles, CA
National Provider Identifier
1861436008
Registry record updated Dec 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
W16009 Issued in CA
Legal business name
PACIFIC HEARING , INC
Practice address
11645 Wilshire Blvd
Suite # 600
Los Angeles, CA 90025-1708
Phone
(310) 477-5558
Fax
(310) 477-7281
NPI assigned
Jun 16, 2006
Last updated
Dec 7, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2011

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.NPI 1023051588
Title
President
Phone
(310) 477-5558

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)CodeLicenseStatePrimary
Specialist 174400000X W16009 CA Primary

Addresses

Primary practice location

11645 Wilshire Blvd
Suite # 600
Los Angeles, CA 90025-1708

Mailing address

11645 Wilshire Blvd
Suite # 600
Los Angeles, CA 90025-1708
Phone (310) 477-5558

Other identifiers 1

IdentifierTypeStateIssuer
GAU000791MedicaidCA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040414001731 CA Part B Supplier - Clinic/Group Practice 1355336967 Receives reassigned benefits from 11 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory
Tax ID family
Pacific Hearing2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11645 Wilshire Blvd
#601B
Los Angeles, CA 90025
Phone (310) 477-5558

11645 Wilshire Blvd
Ste 601B
Los Angeles, CA 90025

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323216000000",
    "number": "1861436008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD",
            "address_2": "SUITE # 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251708",
            "telephone_number": "310-477-5558",
            "fax_number": "310-477-7281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11645 WILSHIRE BLVD",
            "address_2": "SUITE # 600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251708",
            "telephone_number": "310-477-5558",
            "fax_number": "310-477-7281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC HEARING , INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-16",
        "last_updated": "2011-12-07",
        "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": "310-477-5558",
        "authorized_official_credential": "AU.D., PH.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "W16009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GAU000791",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.