Organization
AGE SMART MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HARENDRA IPALAWATTE MD (OWNER)
(818) 439-2160
Entity
Organization
Contact information
Practice address
3435 E THOUSAND OAKS BLVD, THOUSAND OAKS, CA 91359-7901
(818) 439-2160
Mailing address
3435 E THOUSAND OAKS BLVD, THOUSAND OAKS, CA 91359-7901
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/19/2025
Last updated
05/19/2025
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