Individual provider Active NPI

Damiano Impastato Jr.

  • Student in an Organized Health Care Education/Training Program
  • Camarillo, CA
National Provider Identifier
1003224320
Registry record updated Jul 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1750 S Lewis Rd
Camarillo, CA 93012-8520
Phone
(805) 765-9050
NPI assigned
Jul 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1750 S Lewis Rd
Camarillo, CA 93012-8520

Mailing address

28915 Thousand Oaks Blvd
Unit 285
Agoura Hills, CA 91301-2136

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1406678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406678400000",
    "number": "1003224320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28915 THOUSAND OAKS BLVD",
            "address_2": "UNIT 285",
            "city": "AGOURA HILLS",
            "state": "CA",
            "postal_code": "913012136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 S LEWIS RD",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930128520",
            "telephone_number": "805-765-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMPASTATO",
        "first_name": "DAMIANO",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-30",
        "last_updated": "2014-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.