Healthcare Provider Details

I. General information

NPI: 1093753931
Provider Name (Legal Business Name): OXNARD ADVANCED DIAGNOSTIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 HOBSON WAY SUITE 103
OXNARD CA
93030-6706
US

IV. Provider business mailing address

650 HOBSON WAY SUITE 103
OXNARD CA
93030-6706
US

V. Phone/Fax

Practice location:
  • Phone: 805-487-2606
  • Fax: 805-487-2602
Mailing address:
  • Phone: 805-487-2606
  • Fax: 805-487-2602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. JANETTE ANDERSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 805-487-2606