Provider Demographics
NPI:1124425855
Name:HEARING AND BALANCE CENTER INC
Entity type:Organization
Organization Name:HEARING AND BALANCE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:VITULLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-917-4165
Mailing Address - Street 1:16311 VENTURA BLVD STE 841
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4397
Mailing Address - Country:US
Mailing Address - Phone:818-981-7464
Mailing Address - Fax:818-981-6328
Practice Address - Street 1:16311 VENTURA BLVD
Practice Address - Street 2:SUITE 841
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2124
Practice Address - Country:US
Practice Address - Phone:818-981-7464
Practice Address - Fax:818-981-6328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAUD1135A231H00000X, 237700000X, 231HA2400X, 237600000X
CAAU1135237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Multi-Specialty
No231HA2400XSpeech, Language and Hearing Service ProvidersAudiologistAssistive Technology PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1821139601Medicaid
CA1821139601Medicare NSC