Thousand Oaks Diagnostic Imaging Center

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

THOUSAND OAKS DIAGNOSTIC IMAGING CENTER

Doing business as

Camarillo-Los Robles Imaging Center

Practice address

3801 Las Posas Rd
Suite 111
Camarillo, CA 93010-1427

Phone

(805) 492-8032

Fax

(805) 482-2431

NPI assigned

Dec 6, 2006

Organization subpart

Yes

Parent organization

THOUSAND OAKS DIAGNOSTIC IMAGING CENTERAs reported in NPPES

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

Authorized official

Name

Dr. Barry Klein, M.D.

Title

Managing Partner

Phone

(805) 495-9442

Specialties & licenses 1

Addresses

Other names 1

• Camarillo-Los Robles Imaging Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Thousand Oaks Diagnostic Imaging Center

  • Diagnostic Radiology Physician
  • Thousand Oaks, CA
  • NPI 1437127693

  O20091020000259

  Same enrollment
• Thousand Oaks Diagnostic Imaging Center

  • Diagnostic Radiology Physician
  • Thousand Oaks, CA
  • NPI 1629058466

  O20091020000259

  Same enrollment

Part of

Thousand Oaks Diagnostic Imaging Center

Locations

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659312000000",
    "number": "1417016320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51038",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900515338",
            "telephone_number": "805-495-8050",
            "fax_number": "805-496-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 LAS POSAS RD",
            "address_2": "SUITE 111",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930101427",
            "telephone_number": "805-492-8032",
            "fax_number": "805-482-2431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOUSAND OAKS DIAGNOSTIC IMAGING CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THOUSAND OAKS DIAGNOSTIC IMAGING CENTER",
        "enumeration_date": "2006-12-06",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "805-495-9442",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Camarillo-Los Robles Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Camarillo-Los Robles Imaging Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Krestin Tidwell

• Diagnostic Radiology Physician in Camarillo, CA
• Providers in Camarillo, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.