Unknown Individual – Audiologist, NPI 1053304899

Unknown Individual is a healthcare provider. based in San diego, California. specializing in Audiologist. They hold a License No. H2797 (CA). The NPI Number for Unknown Individual is 1053304899

Main info

Organization
Inactive
38 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1053304899
Phone
(619) 298-8546
Address
4747 MISSION BLVD
Deactivation Date
29 April 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1988 (38 years ago)
PAC ID
3870530348
Professional Enrollment ID
I20050426000793
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience18
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 4747, Mission Boulevard, San Diego, San Diego County, California, 92109, United States

    STE 6

    SAN DIEGO, CA 921092541

    Phone: (619) 298-8546

    Fax: (858) 272-3284

    Type: Mailing

  • 4th Avenue, Otay, Chula Vista, San Diego County, California, 92154, United States

    STE 410 A

    SAN DIEGO, CA 921032116

    Phone: (619) 298-8546

    Fax: (619) 298-8593

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92109)

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Provider's Procedures

Unknown Individual performs procedures in Audiologist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
QUALIFIED AUDIOLOGISTCA92567Eardrum testing using ear probe6262

Reviews

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Frequently asked questions

Does Unknown Individual share an NPI with anyone else?
NPI numbers are unique to each provider or organization — Unknown Individual uses 1053304899.
Why is Unknown Individual marked inactive in the NPI directory?
The public NPI listing for Unknown Individual is not currently active; confirm directly with the practice or licensing boards.
What taxonomy line describes Unknown Individual?
For research purposes, treat Unknown Individual as Audiologist in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect Unknown Individual on a map?
Expect San Diego, California as a primary anchor for Unknown Individual unless the record lists multiple sites.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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