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General NPI Number Information
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NPI Number | 1730498957
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Entity Type | Organization
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Legal Business Name | THOUSAND OAKS HEART CENTER
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Dates
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Enumeration Date | 10/05/2010
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Last Update Date | 10/05/2010
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Provider Practice Location Address
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Address Line | 2100 LYNN RD 205
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-1935
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Country | US
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Telephone | 805-497-7594
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Fax |
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Provider Business Mailing Address
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Address Line | 2100 LYNN RD 205
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-1935
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Country | US
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Telephone | 805-497-7594
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. SANJIV GOEL
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Credential | MD
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Telephone | 805-497-7594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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