Active NPI
Manijeh Ezatvar, RPT
- Specialist
- Thousand Oaks, CA
National Provider Identifier
1598909855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 19200
- Practice address
- 1000 Newbury Rd
Suite 120
Thousand Oaks, CA 91320-6435 - Phone
- (805) 375-0001
- Fax
- (805) 375-2221
- NPI assigned
- Apr 29, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 19200 | CA | Primary |
Addresses
Primary practice location
1000 Newbury Rd
Suite 120
Thousand Oaks, CA 91320-6435
Mailing address
1000 Newbury Rd
Suite 120
Thousand Oaks, CA 91320-6435
Phone (805) 375-0001
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240963200000",
"number": "1598909855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 NEWBURY RD",
"address_2": "SUITE 120",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913206435",
"telephone_number": "805-375-0001",
"fax_number": "805-375-2221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 NEWBURY RD",
"address_2": "SUITE 120",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913206435",
"telephone_number": "805-375-0001",
"fax_number": "805-375-2221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZATVAR",
"first_name": "MANIJEH",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-04-29",
"last_updated": "2009-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "CA",
"license": "19200",
"primary": true
}
],
"identifiers": [],
"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 Apr 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.