Basic Information
| Provider Information | |||||||||
| NPI: | 1285135749 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PFAFFMANN | ||||||||
| FirstName: | BLAISE | ||||||||
| MiddleName: | S | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1301 W PROVIDENCE AVE | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928683892 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7146394990 | ||||||||
| FaxNumber: | 7142210977 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 W PROVIDENCE AVE | ||||||||
| Address2: | |||||||||
| City: | ORANGE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928683892 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7142210977 | ||||||||
| FaxNumber: | 7142210977 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2018 | ||||||||
| LastUpdateDate: | 06/23/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/22/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 31008 | OR | N | Speech, Language and Hearing Service Providers | Audiologist | 231HA2400X | N | Speech, Language and Hearing Service Providers | Audiologist | Assistive Technology Practitioner | 231HA2500X | N | Speech, Language and Hearing Service Providers | Audiologist | Assistive Technology Supplier | 237600000X | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 231H00000X | 3693 | CA | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.