Complete Performance Sports Medicine and Longevity Center, Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COMPLETE PERFORMANCE SPORTS MEDICINE AND LONGEVITY CENTER, INC

Practice address

101 Hodencamp Rd
Thousand Oaks, CA 91360-5836

Phone

(805) 777-7003

Fax

(805) 777-7043

NPI assigned

Oct 19, 2021

Last updated

Oct 19, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chris Alvarez

Title

Owner

Phone

(805) 777-7003

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christian Alvarez, DC

  • Chiropractor
  • Thousand Oaks, CA
  • NPI 1477729150
  Medicare reassignment NPD
• Aaron N Smith

  • Hospitalist Physician
  • Emeryville, CA
  • NPI 1780028993

  Internal Medicine

  Medicare reassignment NPD

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1821751520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 HODENCAMP RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605836",
            "telephone_number": "805-777-7003",
            "fax_number": "805-777-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 HODENCAMP RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605836",
            "telephone_number": "805-777-7003",
            "fax_number": "805-777-7043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE PERFORMANCE SPORTS MEDICINE AND LONGEVITY CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-777-7003"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.