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General NPI Number Information
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NPI Number | 1215979844
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Entity Type | Organization
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Legal Business Name | CSE MEDICAL GROUP INC.
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 03/09/2021
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Provider Practice Location Address
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Address Line | 351 ROLLING OAKS DR STE 102
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City | THOUSAND OAKS
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State | CA
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Zip | 91361-1279
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Country | US
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Telephone | 805-497-3744
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Fax | 805-497-1663
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Provider Business Mailing Address
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Address Line | 351 ROLLING OAKS DR 102
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City | THOUSAND OAKS
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State | CA
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Zip | 91361-1275
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Country | US
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Telephone | 805-497-3744
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Fax | 805-497-1663
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEVEN CORWIN
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Credential | M.D.
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Telephone | 805-497-3744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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