| |
9888 Genesee Ave, La Jolla, CA 92037-1205 | |
(215) 720-6183 | |
(619) 924-4191 |
Full Name | |
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Type | Facility |
Speciality | Specialist/technologist, Other - Electroneurodiagnostic |
Location | 9888 Genesee Ave, La Jolla, California |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1841792041 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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231H00000X | Audiologist | (* (Not Available)) | Secondary |
246ZE0600X | Specialist/technologist, Other - Electroneurodiagnostic | (* (Not Available)) | Primary |
Provider Name | Shannon Elizabeth Myers |
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Provider Type | Practitioner - Qualified Audiologist |
Provider Identifiers | NPI Number: 1225273386 PECOS PAC ID: 0840323051 Enrollment ID: I20100809000222 |
Mailing Address | Practice Location Address |
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3432 Grim Ave, San Diego, CA 92104-4225 Ph: (215) 720-6183 | 9888 Genesee Ave, La Jolla, CA 92037-1205 Ph: (215) 720-6183 |