Healthcare Provider Details

I. General information

NPI: 1811019938
Provider Name (Legal Business Name): TOM MEASLES MD PROF CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2190 LYNN RD STE 320
THOUSAND OAKS CA
91360-1980
US

IV. Provider business mailing address

2190 LYNN RD STE 320
THOUSAND OAKS CA
91360-1980
US

V. Phone/Fax

Practice location:
  • Phone: 805-370-5444
  • Fax: 805-370-5515
Mailing address:
  • Phone: 805-370-5444
  • Fax: 805-370-5515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA67464
License Number StateCA

VIII. Authorized Official

Name: DR. TOM F MEASLES
Title or Position: OWNER AND CEO
Credential: M.D.
Phone: 805-370-5444