Healthcare Provider Details

I. General information

NPI: 1326411067
Provider Name (Legal Business Name): AMIGO BABY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2015
Last Update Date: 11/02/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 N RICE AVE STE 325
OXNARD CA
93030-7912
US

IV. Provider business mailing address

PO BOX 6757
THOUSAND OAKS CA
91359-6757
US

V. Phone/Fax

Practice location:
  • Phone: 805-485-7000
  • Fax:
Mailing address:
  • Phone: 805-901-1237
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PABLO VELEZ
Title or Position: CEO/PROGRAM DIRECTOR
Credential:
Phone: 805-901-1237