Healthcare Provider Details
I. General information
NPI: 1164348009
Provider Name (Legal Business Name): CLARITY SURGICAL GROUP, A PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
375 ROLLING OAKS DR STE 115
THOUSAND OAKS CA
91361-1000
US
IV. Provider business mailing address
1534 N MOORPARK RD # 346
THOUSAND OAKS CA
91360-5129
US
V. Phone/Fax
- Phone: 909-224-9848
- Fax:
- Phone: 909-224-9848
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANDREA
PAKULA
Title or Position: MD/CEO
Credential: MD
Phone: 909-224-9848