| Rosaasen Family Medicine, Inc. | |
|
187 E Wilbur Rd # 100 Thousand Oaks CA 91360-5572 | |
| (805) 492-1015 | |
| (805) 492-2035 |
| Full Name | Rosaasen Family Medicine, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 187 E Wilbur Rd # 100, Thousand Oaks, California |
| Authorized Official Name and Position | Jonathan Rosaasen (PRESIDENT) |
| Authorized Official Contact | 8054921015 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rosaasen Family Medicine, Inc. 187 E Wilbur Rd # 100 Thousand Oaks CA 91360-5572 Ph: (805) 492-1015 | Rosaasen Family Medicine, Inc. 187 E Wilbur Rd # 100 Thousand Oaks CA 91360-5572 Ph: (805) 492-1015 |
| NPI Number | 1841636198 |
|---|---|
| Provider Enumeration Date | 05/14/2013 |
| Last Update Date | 10/13/2020 |
| Medicare PECOS PAC ID | 4082857396 |
|---|---|
| Medicare Enrollment ID | O20130904000987 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841636198 | NPI | - | NPPES |
| 1174166714 | Other | CA | ESGATE |
| 1497868376 | Other | CA | FAMILY MEDICINE |
| 1528151352 | Other | CA | FAMILY MEDICINE |
| 1073150744 | Other | CA | YOUNG |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Amanda R Rosaasen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497868376 PECOS PAC ID: 8729009014 Enrollment ID: I20051214000677 |
| Provider Name | Jonathan A Rosaasen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528171352 PECOS PAC ID: 1355364118 Enrollment ID: I20060106000447 |
| Provider Name | Kevin Andrew Dobbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134867369 PECOS PAC ID: 1658805536 Enrollment ID: I20241114002724 |
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