Healthcare Provider Details
I. General information
NPI: 1255153730
Provider Name (Legal Business Name): AYHAN YORUK MD A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/28/2024
Last Update Date: 01/29/2025
Certification Date: 01/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
865 PATRIOT DR STE 201
MOORPARK CA
93021-3405
US
IV. Provider business mailing address
PO BOX 7263
WESTLAKE VILLAGE CA
91359-7263
US
V. Phone/Fax
- Phone: 805-768-4198
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0001X |
| Taxonomy | Clinical Cardiac Electrophysiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
AYHAN
YORUK
Title or Position: PRESIDENT
Credential: MD
Phone: 585-275-2222