# AGOURA FAMILY PRACTICE ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** AGOURA FAMILY PRACTICE ASSOCIATES
- **Other names:** Agoura Family Practice Medical Assoicates
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1174995518
- **Legal business name:** AGOURA FAMILY PRACTICE ASSOCIATES
- **Authorized official:** BADER IQBAL M.D. (OWNER)
- **Authorized official phone:** (805) 494-8520

## Contact information

- **Practice address:** 3180 WILLOW LN, SUITE 102, THOUSAND OAKS, CA 91361-4941
- **Practice address phone:** (805) 494-8520
- **Practice address fax:** (888) 431-8819
- **Mailing address:** 2980 N BEVERLY GLEN CIR, SUITE 100, LOS ANGELES, CA 90077-1726
- **Mailing address phone:** (310) 943-4180
- **Mailing address fax:** (888) 431-8819

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | G69473 | CA | Yes |

## Other

- **Enumeration date:** 10/26/2015
- **Last updated:** 10/26/2015