| Memory Health Mds PC | |
|
3302 Woodley Ave Thousand Oaks CA 91362-1170 | |
| (805) 627-4002 | |
| Not Available |
| Full Name | Memory Health Mds PC |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 3302 Woodley Ave, Thousand Oaks, California |
| Authorized Official Name and Position | Preetivi Ellis (CEO) |
| Authorized Official Contact | 3108800745 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Memory Health Mds PC 3302 Woodley Ave Thousand Oaks CA 91362-1170 Ph: (805) 627-4002 | Memory Health Mds PC 3302 Woodley Ave Thousand Oaks CA 91362-1170 Ph: (805) 627-4002 |
| NPI Number | 1174263719 |
|---|---|
| Provider Enumeration Date | 03/31/2022 |
| Last Update Date | 03/31/2022 |
| Certification Date | 03/31/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174263719 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | () | Primary |
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