Healthcare Provider Details

I. General information

NPI: 1497374128
Provider Name (Legal Business Name): ANDREW HORN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2020
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2221 WANKEL WAY
OXNARD CA
93030-0192
US

IV. Provider business mailing address

1203 FLYNN RD UNIT 160
CAMARILLO CA
93012-6203
US

V. Phone/Fax

Practice location:
  • Phone: 805-988-9366
  • Fax: 805-483-3747
Mailing address:
  • Phone: 805-804-4168
  • Fax: 805-830-1177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberA201607
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: