BASLD

NPI # 

Practice Address:

713 Broadway , Ste. E

Chula Vista, CA, 91910-5313

Practice Phone:

619-600-4392

Practice Fax:

619-240-3780

License Number:

SP14252

License State:

CA

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Hearing and Speech

Taxonomy Code:

261QH0700X