Individual
DR. PHILIP ANGELO FARACI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
215 W JANSS RD, THOUSAND OAKS, CA 91360-1847
(805) 852-9100
(805) 852-9101
Mailing address
215 W JANSS RD, THOUSAND OAKS, CA 91360-1847
(805) 852-9100
(805) 852-9101
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
01034774A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
036079395
IL
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
G23163
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01618941
BCBS
IL
05
—
036079395
—
IL
05
—
200060900A
—
IN
05
—
200060900B
—
IN
Enumeration date
07/22/2005
Last updated
01/18/2022
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