Healthcare Provider Details

I. General information

NPI: 1700596111
Provider Name (Legal Business Name): APA MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2022
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4005 MISSION OAKS BLVD UNIT A
CAMARILLO CA
93012-5156
US

IV. Provider business mailing address

4005 MISSION OAKS BLVD UNIT A
CAMARILLO CA
93012-5156
US

V. Phone/Fax

Practice location:
  • Phone: 310-879-5203
  • Fax:
Mailing address:
  • Phone: 310-409-3611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. PEDRAM ENAYATI
Title or Position: AUTHORIZED OFFICIAL
Credential: M.D.
Phone: 310-409-3611