Provider Demographics
NPI:1295904936
Name:MOORPARK FAMILY MEDICINE INC
Entity type:Organization
Organization Name:MOORPARK FAMILY MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:ROSAASEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-648-4004
Mailing Address - Street 1:301 SCIENCE DR
Mailing Address - Street 2:SUITE #190
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-2094
Mailing Address - Country:US
Mailing Address - Phone:805-531-9400
Mailing Address - Fax:805-531-9499
Practice Address - Street 1:301 SCIENCE DR
Practice Address - Street 2:SUITE #190
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-2094
Practice Address - Country:US
Practice Address - Phone:805-531-9400
Practice Address - Fax:805-531-9499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-27
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty