Organization
ROLLING OAKS RADIOLOGY MEDICAL CORP CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT PRINCENTHAL M.D. (MEDICAL DIRECTOR)
(805) 778-1513
Entity
Organization
Contact information
Practice address
415 ROLLING OAKS DR, THOUSAND OAKS, CA 91361-1029
(805) 778-1513
Mailing address
1014 S WESTLAKE BLVD STE 14, PMB 114, WESTLAKE VILLAGE, CA 91361-3133
(805) 778-1513
(805) 267-5115
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG2342
RAILROAD MEDICARE
—
05
—
GR0056260
—
CA
01
—
ZZZ39119Z
BLUE SHIELD
—
01
—
ZZZ65592Z
BLUE SHIELD
—
Enumeration date
05/18/2006
Last updated
02/07/2013
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