Provider Demographics
NPI:1164041422
Name:ADVANCED CARE MULTISPECIALTY MEDICAL GROUP APC
Entity Type:Organization
Organization Name:ADVANCED CARE MULTISPECIALTY MEDICAL GROUP APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HASHIM
Authorized Official - Middle Name:A
Authorized Official - Last Name:MAPARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-909-6580
Mailing Address - Street 1:4000 CALLE TECATE STE 115
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-5285
Mailing Address - Country:US
Mailing Address - Phone:805-485-2400
Mailing Address - Fax:805-233-3025
Practice Address - Street 1:325 ROLLING OAKS DR STE 130
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1286
Practice Address - Country:US
Practice Address - Phone:805-497-7775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-15
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Multi-Specialty