Provider Demographics
NPI:1316344104
Name:UNIVERSITY OF THE PACIFIC
Entity type:Organization
Organization Name:UNIVERSITY OF THE PACIFIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR AUDIOLOGY
Authorized Official - Prefix:DR
Authorized Official - First Name:RUPA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALACHANDRAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:415-400-8225
Mailing Address - Street 1:155 5TH ST
Mailing Address - Street 2:AUDIOLOGY CLINIC
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-2919
Mailing Address - Country:US
Mailing Address - Phone:415-400-8225
Mailing Address - Fax:
Practice Address - Street 1:155 5TH ST
Practice Address - Street 2:AUDIOLOGY CLINIC
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-2919
Practice Address - Country:US
Practice Address - Phone:415-400-8225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-24
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2246231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty