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166 N Moorpark Rd Ste 102-104 Thousand Oaks CA 91360-4405 | |
| (805) 371-4499 | |
| (805) 371-4407 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 166 N Moorpark Rd Ste 102-104, Thousand Oaks, California |
| Authorized Official Name and Position | Erica Nacin (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 8055295370 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 539 Moorpark CA 93020-0539 Ph: (805) 529-5370 | 166 N Moorpark Rd Ste 102-104 Thousand Oaks CA 91360-4405 Ph: (805) 371-4499 |
| NPI Number | 1467981290 |
|---|---|
| Provider Enumeration Date | 06/06/2017 |
| Last Update Date | 01/22/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467981290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
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