Organization
MEMORY HEALTH MDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PREETIVI ELLIS MD (CEO)
(310) 880-0745
Entity
Organization
Contact information
Practice address
3302 WOODLEY AVE, THOUSAND OAKS, CA 91362-1170
(805) 627-4002
Mailing address
3302 WOODLEY AVE, THOUSAND OAKS, CA 91362-1170
(805) 627-4002
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
Other
Enumeration date
03/31/2022
Last updated
03/31/2022
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