NPIMap

Organization Active NPI

Rolling Oaks Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Thousand Oaks, CA
National Provider Identifier
1003216276
Registry record updated Nov 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
A79029 Issued in CA
Legal business name
ROLLING OAKS SURGERY CENTER LLC
Practice address
415 Rolling Oaks Dr
Suite 115
Thousand Oaks, CA 91361-1029
Phone
(805) 373-7073
Fax
(805) 373-1116
NPI assigned
Aug 25, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kouros Azar, M.D.NPI 1508935040
Title
Manager
Phone
(805) 373-7073

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X A79029 CA Primary

Addresses

Primary practice location

415 Rolling Oaks Dr
Suite 115
Thousand Oaks, CA 91361-1029

Mailing address

425 Haaland Dr
Suite 200
Thousand Oaks, CA 91361-5229
Phone (805) 373-7073

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Ambulatory surgical center certification: CCN 05C0002087

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ROLLING OAKS SURGERY CENTER, LLC
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Jun 11, 2015
Last certification
May 14, 2018
Ownership / control type
Proprietary
Facility address
415 E Rolling Oaks Drive, Suite #115
Thousand Oaks, CA 91361

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2089586Rolling Oaks Surgery Center415 E Rolling Oaks Dr Ste 115, Thousand Oaks, CA 91361Certificate of waiverJan 4, 2027

National Provider Directory

National Provider Directory

Locations

415 Rolling Oaks Dr
Ste 11
Thousand Oaks, CA 91361
Phone (805) 373-7073

425 Haaland Dr
Ste 200
Thousand Oaks, CA 91361
Phone (805) 373-7073

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1408924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416441600000",
    "number": "1003216276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 HAALAND DR",
            "address_2": "SUITE 200",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913615229",
            "telephone_number": "805-373-7073",
            "fax_number": "805-373-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 ROLLING OAKS DR",
            "address_2": "SUITE 115",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611029",
            "telephone_number": "805-373-7073",
            "fax_number": "805-373-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLLING OAKS SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-25",
        "last_updated": "2014-11-20",
        "status": "A",
        "authorized_official_last_name": "AZAR",
        "authorized_official_first_name": "KOUROS",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "805-373-7073",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "A79029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.