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General NPI Number Information
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NPI Number | 1730729690
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Entity Type | Organization
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Legal Business Name | PRECISION PHYSICIANS SURGICAL GROUP CORP.
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Dates
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Enumeration Date | 01/08/2020
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Last Update Date | 01/08/2020
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Provider Practice Location Address
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Address Line | 110 JENSEN CT STE 1C
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-7484
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Country | US
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Telephone | 678-596-1344
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 8636
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City | CALABASAS
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State | CA
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Zip | 91372-8636
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Country | US
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Telephone | 770-815-6466
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | REETU DUA
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Credential |
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Telephone | 770-815-6466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty 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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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