Basic Information
| Provider Information | |||||||||
| NPI: | 1003009556 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PAREKH | ||||||||
| FirstName: | MARTINE | ||||||||
| MiddleName: | DOMINIQUE | ||||||||
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| Credential: | AU.D FAAA, CCC-A | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16260 VENTURA BLVD STE 420 | ||||||||
| Address2: | |||||||||
| City: | ENCINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914362241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8187842233 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 16260 VENTURA BLVD | ||||||||
| Address2: | STE 420 | ||||||||
| City: | ENCINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914362203 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8187842233 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2007 | ||||||||
| LastUpdateDate: | 06/15/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AU 2291 | CA | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.