Healthcare Provider Details

I. General information

NPI: 1528753472
Provider Name (Legal Business Name): LA - VENTURA SURGERY CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2023
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 ROLLING OAKS DR STE 110
THOUSAND OAKS CA
91361-1299
US

IV. Provider business mailing address

325 ROLLING OAKS DR STE 110
THOUSAND OAKS CA
91361-1299
US

V. Phone/Fax

Practice location:
  • Phone: 805-778-1122
  • Fax: 805-777-7379
Mailing address:
  • Phone: 805-778-1122
  • Fax: 805-777-7379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0006X
TaxonomyAmbulatory Fertility Facility
License Number
License Number State

VIII. Authorized Official

Name: DONNA HOFFMAN
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 805-778-1122