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General NPI Number Information
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NPI Number | 1790435089
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Entity Type | Organization
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Legal Business Name | CSMN OPERATIONS CA LLC
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Dates
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Enumeration Date | 03/28/2022
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 23410 CIVIC CENTER WAY STE E5
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City | MALIBU
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State | CA
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Zip | 90265-5916
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Country | US
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Telephone | 970-693-0015
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Fax |
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Provider Business Mailing Address
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Address Line | 23410 CIVIC CENTER WAY STE E5
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City | MALIBU
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State | CA
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Zip | 90265-5916
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | CHRISTOPHER AUSTIN
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Credential |
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Telephone | 714-926-5846
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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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