MEDICARE: PER-SE TECHNOLOGIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician		CA

General Provider Information

NPI Number	:	1093841033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PER-SE TECHNOLOGIES

Provider Business Mailing Address
First Line	:	1525 RANCHO CONEJO BLVD
Second Line	:	SUITE 201
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91320-1448
Country	:	US
Telephone Number	:	805-375-8800
Fax Number	:	805-375-8900

Provider Business Practice Location Address
First Line	:	1525 RANCHO CONEJO BLVD
Second Line	:	SUITE 201
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91320-1448
Country	:	US
Telephone Number	:	805-375-8800
Fax Number	:	805-375-8900

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	CHERYL LYNN WILSON
Credential	:
Telephone Number	:	805-375-8801

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	07/21/2008

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