| |
501 Marin St Ste 205, Thousand Oaks, CA 91360-4266 | |
(757) 748-6003 | |
(877) 287-1195 |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 501 Marin St Ste 205, Thousand Oaks, California |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1952855843 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2251S0007X | Physical Therapist - Sports | PT291493 (California) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Provider Name | Gina D. Meyer |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1083638316 PECOS PAC ID: 4082693528 Enrollment ID: I20200108000480 |
Provider Name | Armin Sheikh |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1194599050 PECOS PAC ID: 6709227820 Enrollment ID: I20240507002962 |
Provider Name | Brandon Devalk |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1609623016 PECOS PAC ID: 2466999396 Enrollment ID: I20240808003213 |
Provider Name | Connor Wu |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1356166060 PECOS PAC ID: 0840725818 Enrollment ID: I20241127002293 |
Mailing Address | Practice Location Address |
---|---|
30025 Quail Run Dr, Agoura Hills, CA 91301-4068 Ph: (757) 748-6003 | 501 Marin St Ste 205, Thousand Oaks, CA 91360-4266 Ph: (757) 748-6003 |