Individual
ROY GOTTLIEB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
415 ROLLING OAKS DR, THOUSAND OAKS, CA 91361-1031
(805) 778-1513
Mailing address
PO BOX 190, SIMI VALLEY, CA 93062-0190
(805) 522-5940
(805) 522-6401
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
20A6254
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX62540
—
CA
Enumeration date
05/06/2006
Last updated
02/07/2014
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