MEDICARE: THOUSAND OAKS OUTPATIENT SURGERY CENTER, INC.

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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1114648029
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THOUSAND OAKS OUTPATIENT SURGERY CENTER, INC.

Provider Business Mailing Address
First Line	:	3299 OLD CONEJO RD STE 6
Second Line	:
City	:	NEWBURY PARK
State	:	CA
Zip	:	91320-2152
Country	:	US
Telephone Number	:	818-359-8833
Fax Number	:	877-727-9225

Provider Business Practice Location Address
First Line	:	3299 OLD CONEJO RD STE 6
Second Line	:
City	:	NEWBURY PARK
State	:	CA
Zip	:	91320-2152
Country	:	US
Telephone Number	:	818-359-8833
Fax Number	:	877-727-9225

Authorized Official
Title or Position	:	PRESIDENT
Name	:	PARIZAD HOOSHI
Credential	:
Telephone Number	:	818-469-6344

Provider Enumeration Date	:	09/08/2022
Last Update Date	:	10/13/2022

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