Individual provider · Type 1 NPI

Michael Scott Mortensen, PHYSICIAN ASSISTANT

Medical Physician Assistant · Thousand Oaks, CA

NPI number 1124671532 Active

Practice location

425 Haaland Dr Ste 102
Thousand Oaks, CA 91361-5230

Call (805) 723-8008 Map

Mailing address

3713 Corte De Los Reyes
Thousand Oaks, CA 91360-7025

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X56485 (CA)

Medical Physician Assistant: Definition to come...

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About NPI 1124671532

Michael Scott Mortensen, PHYSICIAN ASSISTANT's National Provider Identifier is 1124671532, issued on Jul 24, 2019. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Thousand Oaks, CA. The record was last updated on Jul 24, 2019.