NPIMap

Organization Active NPI

Premise Health of California Medical, P.C

Doing business as Takeda - Thousand Oaks

  • Multi-Specialty Clinic/Center
  • Thousand Oaks, CA
National Provider Identifier
1619733755
Registry record updated Feb 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PREMISE HEALTH OF CALIFORNIA MEDICAL, P.C
Doing business as
Takeda - Thousand Oaks
Practice address
1700 Rancho Conejo Blvd
Thousand Oaks, CA 91320-1424
Phone
(805) 375-5524
Fax
(805) 480-2577
NPI assigned
Feb 26, 2024
Last updated
Feb 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2024

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

Authorized official

Name
Jonathan Leizman, MD
Title
President
Phone
(615) 468-6270

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

1700 Rancho Conejo Blvd
Thousand Oaks, CA 91320-1424

Mailing address

5500 Maryland Way Ste 120
Brentwood, TN 37027-4993

Other names 1

  • Takeda - Thousand Oaks Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of California Medical PC55 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1700 Rancho Conejo Blvd
Thousand Oaks, CA 91320
Phone (805) 375-5524

NPI Registry JSON

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

{
    "created_epoch": "1708905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708992000000",
    "number": "1619733755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY STE 120",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 RANCHO CONEJO BLVD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913201424",
            "telephone_number": "805-375-5524",
            "fax_number": "805-480-2577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF CALIFORNIA MEDICAL, P.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-02-27",
        "certification_date": "2024-02-27",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-468-6270",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Takeda - Thousand Oaks",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 27, 2024; 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.