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General NPI Number Information
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NPI Number | 1871798512
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Entity Type | Organization
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Legal Business Name | VILLAGE OB GYN MEDICAL GROUP INC
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Dates
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Enumeration Date | 06/20/2007
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Last Update Date | 10/25/2007
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Provider Practice Location Address
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Address Line | 317 SO MOORPARK ROAD
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City | THOUSAND OAKS
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State | CA
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Zip | 91361
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Country | US
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Telephone | 805-497-8638
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Fax | 805-495-3858
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Provider Business Mailing Address
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Address Line | 317 SO MOORPARK ROAD
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City | THOUSAND OAKS
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State | CA
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Zip | 91361
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Country | US
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Telephone | 805-497-8638
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Fax | 805-495-3858
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Authorized Official
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Title or Position | PRESIDENT
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Name | STANLEY R SILVERMAN
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Credential | MD
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Telephone | 805-497-8638
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A75365
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C27941
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License Number State | CA
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