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General NPI Number Information
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NPI Number | 1831428861
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Entity Type | Organization
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Legal Business Name | OAK TREE SURGICAL CENTER LLC
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Dates
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Enumeration Date | 12/22/2009
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Last Update Date | 05/18/2012
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Provider Practice Location Address
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Address Line | 2230 LYNN RD SUITE 320
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-1901
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Country | US
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Telephone | 805-371-8400
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Fax | 805-371-8404
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Provider Business Mailing Address
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Address Line | 2230 LYNN RD. SUITE 320
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City | THOUSAND OAKS
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State | CA
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Zip | 91360
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Country | US
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Telephone | 805-371-8400
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Fax | 805-371-8404
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAHRAM DANESHGAR
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Credential | M.D.
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Telephone | 805-371-8404
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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