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General NPI Number Information
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NPI Number | 1174715445
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Entity Type | Organization
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Legal Business Name | DIGESTIVE HEALTH CENTER OF THOUSAND OAKS, LLC
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Dates
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Enumeration Date | 08/10/2007
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Last Update Date | 10/26/2017
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Provider Practice Location Address
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Address Line | 3510 N MOORPARK RD STE 101
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-2688
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Country | US
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Telephone | 805-492-9000
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Fax | 805-492-4100
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Provider Business Mailing Address
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Address Line | 3510 N MOORPARK RD STE 101
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-2688
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Country | US
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Telephone | 805-492-9000
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Fax | 805-492-4100
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Authorized Official
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Title or Position | MANAGER/MEDICAL DIRECTOR
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Name | DR. ALISTER AUGUSTUS GEORGE
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Credential | M.D.
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Telephone | 805-492-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0800X
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Taxonomy Name | Endoscopy Clinic/Center
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License Number |
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License Number State | CA
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