MEDICARE: DELA AMOUSSOU M.D.

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	2084N0400X	Neurology Physician	A136015	CA
2	2084N0400X	Neurology Physician	MD61036554	WA
3	2084N0400X	Neurology Physician	01083749A	IN
4	2084N0400X	Neurology Physician	17301	NV
5	2084N0400X	Neurology Physician	MD198490	OR
6	282N00000X	General Acute Care Hospital	R-916	IA
7	2084N0400X	Neurology Physician	TPME1442	FL

General Provider Information

NPI Number	:	1639464431
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELA AMOUSSOU M.D.

Provider Business Mailing Address
First Line	:	2915 SAMARKAND DR
Second Line	:
City	:	SANTA BARBARA
State	:	CA
Zip	:	93105-3770
Country	:	US
Telephone Number	:	773-368-1306
Fax Number	:

Provider Business Practice Location Address
First Line	:	133 W. SANTA CLARA STREET
Second Line	:
City	:	SIMI VALLEY
State	:	CA
Zip	:	93065
Country	:	US
Telephone Number	:	805-582-4000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2011
Last Update Date	:	12/15/2025

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Directions to “ DELA AMOUSSOU M.D.” Practice Location

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