Oleg Bouimer, CMT

Individual provider Active NPI Massage Therapist · Malibu, CA

NPI 1912372541 · NPPES record last updated Dec 15, 2015

Key facts

NPI
1912372541
Entity type
Individual (NPI type 1)
Primary specialty
Massage Therapist 225700000X
License
24838 (CA)
Practice address
23440 Civic Center Way
Suite 202
Malibu, CA 90265-4854
Phone
(310) 317-9500
Fax
(310) 317-9502
NPI assigned
Dec 8, 2015
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
24838CAMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Corie Tappin L.Ac Acupuncture & Traditional Chinese Medicine Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 24838 CA Yes

Addresses

Primary practice location

23440 Civic Center Way
Suite 202
Malibu, CA 90265-4854

Mailing address

23440 Civic Center Way
Suite 202
Malibu, CA 90265-4854
Phone (310) 317-9500

Other providers in Malibu, CA

All providers in Malibu, CA · Massage Therapist in California

Sources for this page

Verify at the official NPI Registry.