MEDICARE: CAMARILLO SPRINGS HOLISTIC MEDICAL

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1669464715
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAMARILLO SPRINGS HOLISTIC MEDICAL

Provider Business Mailing Address
First Line	:	816 CAMARILLO SPRINGS RD
Second Line	:	#E
City	:	CAMARILLO
State	:	CA
Zip	:	93012-9441
Country	:	US
Telephone Number	:	805-987-1800
Fax Number	:	805-987-5311

Provider Business Practice Location Address
First Line	:	816 CAMARILLO SPRINGS RD
Second Line	:	#E
City	:	CAMARILLO
State	:	CA
Zip	:	93012-9441
Country	:	US
Telephone Number	:	805-987-1800
Fax Number	:	805-987-5311

Authorized Official
Title or Position	:	SECRETARY
Name	:	JAMES A AYLOR
Credential	:	DC
Telephone Number	:	805-987-1800

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	09/15/2010

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