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General NPI Number Information
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NPI Number | 1902436348
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Entity Type | Organization
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Legal Business Name | DLV VISION ASC
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Dates
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Enumeration Date | 01/24/2020
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 3180 WILLOW LN STE 118
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City | THOUSAND OAKS
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State | CA
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Zip | 91361-4986
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Country | US
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Telephone | 310-792-3914
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Fax | 818-707-7668
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Provider Business Mailing Address
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Address Line | 4353 PARK TERRACE DR STE 150
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-4639
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Country | US
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Telephone | 805-987-5300
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Fax | 818-707-7668
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Authorized Official
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Title or Position | CHIEF REVENUE OFFICER
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Name | CLIFTON BAZHAW
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Credential |
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Telephone | 214-893-0471
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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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