Organization
LOS ROBLES CPSP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY P BLOCK M.D. (MEDICAL DIRECTOR)
(805) 496-6613
Entity
Organization
Contact information
Practice address
2220 LYNN RD STE 107B, THOUSAND OAKS, CA 91360-8014
(805) 373-5707
(805) 375-0711
Mailing address
1534 N MOORPARK RD STE 116, THOUSAND OAKS, CA 91360-5129
(805) 373-5707
(805) 495-0711
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
GR0064740
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0064740
—
CA
Enumeration date
03/30/2007
Last updated
08/22/2020
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