| Complete Performance Sports Medicine And Longevity Center, Inc | |
|
101 Hodencamp Rd Thousand Oaks CA 91360-5836 | |
| (805) 777-7003 | |
| (805) 777-7043 |
| Full Name | Complete Performance Sports Medicine And Longevity Center, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 101 Hodencamp Rd, Thousand Oaks, California |
| Authorized Official Name and Position | Chris Alvarez (OWNER) |
| Authorized Official Contact | 8057777003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Complete Performance Sports Medicine And Longevity Center, Inc 101 Hodencamp Rd Thousand Oaks CA 91360-5836 Ph: (805) 777-7003 | Complete Performance Sports Medicine And Longevity Center, Inc 101 Hodencamp Rd Thousand Oaks CA 91360-5836 Ph: (805) 777-7003 |
| NPI Number | 1821751520 |
|---|---|
| Provider Enumeration Date | 10/19/2021 |
| Last Update Date | 10/19/2021 |
| Medicare PECOS PAC ID | 1658762653 |
|---|---|
| Medicare Enrollment ID | O20211230001203 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821751520 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| Provider Name | Aaron N Smith |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780028993 PECOS PAC ID: 5890081129 Enrollment ID: I20160912002539 |
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