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General NPI Number Information
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NPI Number | 1669464715
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Entity Type | Organization
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Legal Business Name | CAMARILLO SPRINGS HOLISTIC MEDICAL
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Dates
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Enumeration Date | 08/16/2005
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Last Update Date | 09/15/2010
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Provider Practice Location Address
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Address Line | 816 CAMARILLO SPRINGS RD #E
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City | CAMARILLO
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State | CA
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Zip | 93012-9441
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Country | US
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Telephone | 805-987-1800
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Fax | 805-987-5311
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Provider Business Mailing Address
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Address Line | 816 CAMARILLO SPRINGS RD #E
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City | CAMARILLO
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State | CA
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Zip | 93012-9441
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Country | US
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Telephone | 805-987-1800
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Fax | 805-987-5311
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Authorized Official
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Title or Position | SECRETARY
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Name | JAMES A AYLOR
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Credential | DC
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Telephone | 805-987-1800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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