Provider Demographics
NPI:1336259134
Name:OTONIX INC
Entity type:Organization
Organization Name:OTONIX INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IZHAK
Authorized Official - Middle Name:
Authorized Official - Last Name:PAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-260-7420
Mailing Address - Street 1:1700 E CESAR E CHAVEZ AVE
Mailing Address - Street 2:STE 2300
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-2424
Mailing Address - Country:US
Mailing Address - Phone:818-788-4513
Mailing Address - Fax:818-788-4523
Practice Address - Street 1:1700 EAST CESAR CHAVEZ AVE.
Practice Address - Street 2:STE # 2300
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-260-7420
Practice Address - Fax:323-260-7426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 2371231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW20133Medicare PIN