NPIMap

Organization Active NPI

Simi San Fernando Valley Urology Associates

  • Specialist
  • Thousand Oaks, CA
National Provider Identifier
1184724502
Registry record updated Jun 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A37982 Issued in CA
Legal business name
SIMI SAN FERNANDO VALLEY UROLOGY ASSOCIATES
Practice address
2190 Lynn Rd
Suite 290
Thousand Oaks, CA 91360-1980
Phone
(805) 373-8611
Fax
(805) 373-2857
NPI assigned
Sep 25, 2006
Last updated
Jun 4, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2010

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

Authorized official

Name
Dr. Muni Nanjunda Reddy, MD
Title
Sr. Partner
Phone
(805) 373-8611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X A37982 CA Primary

Addresses

Primary practice location

2190 Lynn Rd
Suite 290
Thousand Oaks, CA 91360-1980

Mailing address

2100 Lynn Rd
Suite 250
Thousand Oaks, CA 91360-1935
Phone (805) 373-8611

Other identifiers 2

IdentifierTypeStateIssuer
096608547OtherCASS#
00A379820MedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Simi San Fernando Valley Urology Associates4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2100 Lynn Rd
Ste 250
Thousand Oaks, CA 91360
Phone (805) 373-8611

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275609600000",
    "number": "1184724502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 LYNN RD",
            "address_2": "SUITE 250",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601935",
            "telephone_number": "805-373-8611",
            "fax_number": "805-373-2857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2190 LYNN RD",
            "address_2": "SUITE 290",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601980",
            "telephone_number": "805-373-8611",
            "fax_number": "805-373-2857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMI SAN FERNANDO VALLEY UROLOGY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2010-06-04",
        "status": "A",
        "authorized_official_last_name": "REDDY",
        "authorized_official_first_name": "MUNI",
        "authorized_official_middle_name": "NANJUNDA",
        "authorized_official_title_or_position": "SR. PARTNER",
        "authorized_official_telephone_number": "805-373-8611",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A37982",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SS#",
            "identifier": "096608547",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A379820",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; 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.