Organization
NOVAXX INC
Active
Other names
Womens Pathology Services
Organization subpart
No
Provider details
NPI number
Authorized official
DEAN L MOYER MD (PRESIDENT)
(805) 230-3155
Entity
Organization
Contact information
Practice address
2955 E HILLCREST DRIVE, #102, THOUSAND OAKS, CA 91362-3177
(805) 230-3155
(805) 230-3153
Mailing address
PO BOX 25420, VENTURA, CA 93002-2277
(805) 650-5910
(805) 650-5972
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0969930
CLIA
CA
01
—
05D969930
HEALTH CARE FIN ADMIN
CA
01
—
ZZZ070482
BLUE SHIELD OF CA
CA
Enumeration date
11/25/2006
Last updated
05/02/2008
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