1124054978 NPI number — THOUSAND OAKS SURGICAL HOSPITAL A CALIFORNIA LIMITED PARTNERSHIP

Table of content: (NPI 1124054978)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124054978 NPI number — THOUSAND OAKS SURGICAL HOSPITAL A CALIFORNIA LIMITED PARTNERSHIP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THOUSAND OAKS SURGICAL HOSPITAL A CALIFORNIA LIMITED PARTNERSHIP
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:
1124054978
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9301 N CENTRAL EXPY
Provider Second Line Business Mailing Address:
TOWER II STE 360
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75231-0806
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-217-0100
Provider Business Mailing Address Fax Number:
214-217-0015

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 ROLLING OAKS DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
THOUSAND OAKS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91361-1050
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-418-1251
Provider Business Practice Location Address Fax Number:
805-418-1381
Provider Enumeration Date:
06/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CORLEY
Authorized Official First Name:
CRAIG
Authorized Official Middle Name:
E
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
805-418-1252

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  050000596 , 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)





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