Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 20A8764 | CA |
NPI | 1023078342 |
---|---|
Provider Name | Dr. David R Ghausi |
First Address | Thousand Oaks, CA 91360-1904 |
Second Address | Thousand Oaks, CA 91360-8004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/03/2006 |
Last Update Date | 20/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023078342 | (05) | CA |
I53663 | (02) | CA |