Healthcare Provider Details

I. General information

NPI: 1154865640
Provider Name (Legal Business Name): ALLURE MEDICAL GROUP A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2016
Last Update Date: 12/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2975 SYCAMORE DR
SIMI VALLEY CA
93065-1201
US

IV. Provider business mailing address

501 S REINO RD 200
NEWBURY PARK CA
91320-4269
US

V. Phone/Fax

Practice location:
  • Phone: 805-955-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: PEDRAM BAGHERI
Title or Position: VICE PRESIDENT
Credential: MD
Phone: 805-822-4517