NPI 1598909855

Manijeh Ezatvar, RPT

Practitioner Specialist Thousand Oaks, CA

Practice location

Address: 1000 Newbury Rd Suite 120, Thousand Oaks, CA 91320-6435
Phone: (805) 375-0001
Fax: (805) 375-2221

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 19200 (CA)

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Registry record

NPI: 1598909855
Entity type: Individual
Sex (as registered): Female
NPI issued: 29 Apr 2009
Record last updated: 29 Apr 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.