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General NPI Number Information
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NPI Number | 1821062316
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Entity Type | Individual
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Provider Name | ALBERTO JOSE ODIO M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 03/12/2020
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Provider Practice Location Address
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Address Line | 2925 SYCAMORE DR SUITE 204/205
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City | SIMI VALLEY
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State | CA
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Zip | 93065-1207
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Country | US
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Telephone | 805-578-9620
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Fax | 805-955-0498
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Provider Business Mailing Address
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Address Line | 2925 SYCAMORE DR SUITE 204/205
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City | SIMI VALLEY
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State | CA
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Zip | 93065-1207
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Country | US
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Telephone | 805-578-9620
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Fax | 805-583-0414
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | G41862
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License Number State | CA
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