Healthcare Provider Details

I. General information

NPI: 1669629929
Provider Name (Legal Business Name): ARKADY KOROTINSKY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OUTLET CENTER DR SUITE 225
OXNARD CA
93036-0607
US

IV. Provider business mailing address

2000 OUTLET CENTER DR SUITE 225
OXNARD CA
93036-0607
US

V. Phone/Fax

Practice location:
  • Phone: 805-604-6960
  • Fax:
Mailing address:
  • Phone: 805-604-6960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License NumberA130135
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: