Healthcare Provider Details

I. General information

NPI: 1700123569
Provider Name (Legal Business Name): HERA HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2013
Last Update Date: 01/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3180 WILLOW LN SUITE 108
THOUSAND OAKS CA
91361-4941
US

IV. Provider business mailing address

3180 WILLOW LN SUITE 108
THOUSAND OAKS CA
91361-4941
US

V. Phone/Fax

Practice location:
  • Phone: 805-379-9110
  • Fax: 805-379-9111
Mailing address:
  • Phone: 805-379-9110
  • Fax: 805-379-9111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MIRELA CERNAIANU
Title or Position: PRESIDENT
Credential: M.D.
Phone: 805-379-9110