COUNTY OF VENTURA

NPI # 

Practice Address:

125 W Thousand Oaks Blvd , Suite 300

Thousand Oaks, CA, 91360-4402

Practice Phone:

805-418-9100

Practice Fax:

805-370-0619

License Number:

H80CS00247-06-03

License State:

CA

Taxonomy Grouping:

Ambulatory Health Care Facilities

Taxonomy Classification:

Clinic/Center

Taxonomy Specialization:

Federally Qualified Health Center (FQHC)

Taxonomy Code:

261QF0400X