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Organization
PETER J MARINCOVICH
Active
Organization
PETER J MARINCOVICH
Active
Other names
Audiology Associates
Organization subpart
No
Provider details
NPI number
Authorized official
PETER JANSEN MARINCOVICH PHD AUDIOLOGIST DISP (OWNER AUDIOLOGIST)
(707) 523-4740
Entity
Organization
Contact information
Practice address
1111 SONOMA AVE, SUITE 316, SANTA ROSA, CA 95405-4819
(707) 523-4740
(707) 523-0231
Mailing address
1111 SONOMA AVE, SUITE 316, SANTA ROSA, CA 95405-4819
(707) 523-4740
(707) 523-0231
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
AU758
CA
237600000X
Audiologist-Hearing Aid Fitter
HA1949
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
640002077
RRM
CA
05
—
AU0007580
—
CA
01
—
ZZZ03361Z
BLUE SHIELD
CA
01
—
ZZZ03362Z
BLUE SHIELD
CA
Enumeration date
10/06/2006
Last updated
03/13/2013
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