Basic Information
| Provider Information | |||||||||
| NPI: | 1306942743 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SAN FRANCISCO AUDIOLOGY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2100 WEBSTER ST STE 202 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941152375 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4159233134 | ||||||||
| FaxNumber: | 4159233132 | ||||||||
| Practice Location | |||||||||
| Address1: | 2100 WEBSTER ST STE 202 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941152375 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4159233134 | ||||||||
| FaxNumber: | 4159233132 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/15/2006 | ||||||||
| LastUpdateDate: | 05/05/2010 | ||||||||
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| AuthorizedOfficialLastName: | GALLAGHER | ||||||||
| AuthorizedOfficialFirstName: | THERESA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DOCTOR OF AUDIOLOGY | ||||||||
| AuthorizedOfficialTelephone: | 4159233134 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | AU.D | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QH0700X | AU1395 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech |
No ID Information.