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General NPI Number Information
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NPI Number | 1801299581
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Entity Type | Organization
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Legal Business Name | THERMAL IMAGING OF SOCAL, LLC
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Dates
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Enumeration Date | 10/08/2014
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Last Update Date | 10/08/2014
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Provider Practice Location Address
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Address Line | 3625 E THOUSAND OAKS BLVD
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91362-3626
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Country | US
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Telephone | 310-463-2318
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Fax |
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Provider Business Mailing Address
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Address Line | 32855 MULHOLLAND HWY
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City | MALIBU
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State | CA
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Zip | 90265-2430
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Country | US
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Telephone | 310-463-2318
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MS. MARJORIE HOLT
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Credential | CCT
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Telephone | 310-463-2318
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number |
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License Number State |
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