Organization
MICHAEL T. VERCILLO, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL T VERCILLO M.D. (PRESIDENT, CEO)
(310) 600-0111
Entity
Organization
Contact information
Practice address
375 ROLLING OAKS DR, SUITE 200, THOUSAND OAKS, CA 91361-1023
(805) 497-9481
(805) 497-3416
Mailing address
375 ROLLING OAKS DR, SUITE 200, THOUSAND OAKS, CA 91361-1023
(805) 497-9481
(805) 497-3416
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A85526
CA
Other
Enumeration date
04/01/2010
Last updated
04/01/2010
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