1861557985 NPI number — KARIE MCMURRAY MD INC A MEDICAL CORPORATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861557985 NPI number — KARIE MCMURRAY MD INC A MEDICAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KARIE MCMURRAY MD INC A MEDICAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861557985
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/27/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
415 E ROLLING OAKS DR
Provider Second Line Business Mailing Address:
SUITE 260
Provider Business Mailing Address City Name:
THOUSAND OAKS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91361
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-371-4700
Provider Business Mailing Address Fax Number:
805-371-4713

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
415 E ROLLING OAKS DR
Provider Second Line Business Practice Location Address:
SUITE 260
Provider Business Practice Location Address City Name:
THOUSAND OAKS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91361
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-371-4700
Provider Business Practice Location Address Fax Number:
805-371-4713
Provider Enumeration Date:
12/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MCMURRAY
Authorized Official First Name:
KARIE
Authorized Official Middle Name:
T
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
805-371-4700

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  G60307 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00G60307 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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