Provider Demographics
NPI:1003843244
Name:SEVEN OAKS REHABILITATION & FITNESS CENTER INC
Entity Type:Organization
Organization Name:SEVEN OAKS REHABILITATION & FITNESS CENTER INC
Other - Org Name:SEVEN OAKS REHAB & FITNESS CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:POLLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MEDCALF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-373-6560
Mailing Address - Street 1:141 TRIUNFO CANYON ROAD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2525
Mailing Address - Country:US
Mailing Address - Phone:805-373-6560
Mailing Address - Fax:805-373-5120
Practice Address - Street 1:141 TRIUNFO CANYON ROAD
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2525
Practice Address - Country:US
Practice Address - Phone:805-373-6560
Practice Address - Fax:805-373-5120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225100000X
2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W15085Medicare ID - Type Unspecified