Provider Demographics
NPI:1447577879
Name:HALL, JEFFREY D
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:D
Last Name:HALL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7676 HAZARD CENTER DR
Mailing Address - Street 2:STE 500
Mailing Address - City:SAN DEIGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-4508
Mailing Address - Country:US
Mailing Address - Phone:619-600-7547
Mailing Address - Fax:619-632-4758
Practice Address - Street 1:7676 HAZARD CENTER DR
Practice Address - Street 2:STE 500
Practice Address - City:SAN DEIGO
Practice Address - State:CA
Practice Address - Zip Code:92108-4508
Practice Address - Country:US
Practice Address - Phone:619-600-7547
Practice Address - Fax:619-632-4758
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-25
Last Update Date:2014-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA 7600237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist