Healthcare Provider Details

I. General information

NPI: 1083892350
Provider Name (Legal Business Name): OAKVIEW HC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2008
Last Update Date: 12/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3557 CAMPUS DR
THOUSAND OAKS CA
91360-2744
US

IV. Provider business mailing address

3557 CAMPUS DR
THOUSAND OAKS CA
91360-2744
US

V. Phone/Fax

Practice location:
  • Phone: 805-241-2000
  • Fax: 805-241-2070
Mailing address:
  • Phone: 805-241-2000
  • Fax: 805-241-2070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number550000791
License Number StateCA

VIII. Authorized Official

Name: GEORGE R BROUCHARD
Title or Position: CEO
Credential:
Phone: 310-923-2192