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General NPI Number Information
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NPI Number | 1992852024
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Entity Type | Organization
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Legal Business Name | ALISTER A. GEORGE, M.D., INC.
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 08/15/2007
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Provider Practice Location Address
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Address Line | 509 MARIN ST SUITE 134
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-4261
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Country | US
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Telephone | 805-495-9488
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Fax | 805-495-9951
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Provider Business Mailing Address
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Address Line | 509 MARIN ST SUITE 134
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-4261
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Country | US
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Telephone | 805-495-9488
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Fax | 805-495-9951
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Authorized Official
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Title or Position | BILLING OFFICER
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Name | EVANGELINE DEASIS
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Credential |
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Telephone | 805-495-9488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G63795
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License Number State | CA
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