Healthcare Provider Details

I. General information

NPI: 1063449403
Provider Name (Legal Business Name): SAIBAL KAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 01/27/2022
Certification Date: 09/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 W JANSS RD STE 340
THOUSAND OAKS CA
91360-1879
US

IV. Provider business mailing address

PO BOX 512717
LOS ANGELES CA
90051-0717
US

V. Phone/Fax

Practice location:
  • Phone: 805-852-9100
  • Fax: 805-852-9101
Mailing address:
  • Phone: 310-423-3977
  • Fax: 310-967-8323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA63816
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License NumberA63816
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: