Basic Information
| Provider Information | |||||||||
| NPI: | 1538560842 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OAKS SURGICAL SPECIALISTS, A MEDICAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 77 ROLLING OAKS DR | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | THOUSAND OAKS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913611011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8053799696 | ||||||||
| FaxNumber: | 8053799695 | ||||||||
| Practice Location | |||||||||
| Address1: | 77 ROLLING OAKS DR | ||||||||
| Address2: | SUITE 203 | ||||||||
| City: | THOUSAND OAKS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913611011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8053799696 | ||||||||
| FaxNumber: | 8053799695 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2014 | ||||||||
| LastUpdateDate: | 01/23/2022 | ||||||||
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| AuthorizedOfficialLastName: | ARNAOUT | ||||||||
| AuthorizedOfficialFirstName: | WALID | ||||||||
| AuthorizedOfficialMiddleName: | S. | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8185770911 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D | ||||||||
| NPICertificationDate: | 01/23/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0127X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 208600000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 1023072816 | 01 | CA | NPI | OTHER |