Individual
AMIT MONGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2530 RENATA CT, THOUSAND OAKS, CA 91362-4918
(805) 870-5282
(805) 277-9751
Mailing address
2530 RENATA CT, THOUSAND OAKS, CA 91362-4918
(805) 870-5282
(805) 277-9751
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
C129345
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700021805
—
IA
01
—
P00741255
RR MEDICARE
IA
Enumeration date
12/04/2008
Last updated
12/17/2015
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