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Organization
PACIFIC COAST WELLNESS
Active
Organization
PACIFIC COAST WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARYOUSH JADALI MD (PRESIDENT)
(805) 777-7406
Entity
Organization
Contact information
Practice address
2100 LYNN RD, THOUSAND OAKS, CA 91360-1935
(805) 777-7406
(805) 557-4583
Mailing address
2100 LYNN RD, THOUSAND OAKS, CA 91360-1935
(805) 777-7406
(805) 557-4583
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
2080N0001X
Neonatal-Perinatal Medicine Physician
—
—
Other
Enumeration date
08/21/2009
Last updated
08/21/2009
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