Provider Demographics
NPI:1144608597
Name:MY HEALTH MEDICAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:MY HEALTH MEDICAL ASSOCIATES, PC
Other - Org Name:MY HEALTH MEDICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:EIFFERT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-278-0804
Mailing Address - Street 1:1710 N MOORPARK RD
Mailing Address - Street 2:SUITE NUMBER 220
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-5133
Mailing Address - Country:US
Mailing Address - Phone:650-278-0804
Mailing Address - Fax:650-618-1461
Practice Address - Street 1:333 S MOORPARK RD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1008
Practice Address - Country:US
Practice Address - Phone:650-278-0804
Practice Address - Fax:650-618-1461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-18
Last Update Date:2015-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79039207R00000X, 207RA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction MedicineGroup - Multi-Specialty