Provider Demographics
NPI:1346857802
Name:SOS ENVIRONMENTAL HEALTH
Entity Type:Organization
Organization Name:SOS ENVIRONMENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:G
Authorized Official - Last Name:COLBY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:310-748-3668
Mailing Address - Street 1:317 W VENTURA BLVD # 1026
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-9134
Mailing Address - Country:US
Mailing Address - Phone:310-748-3668
Mailing Address - Fax:
Practice Address - Street 1:317 W VENTURA BLVD # 1026
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-9134
Practice Address - Country:US
Practice Address - Phone:310-748-3668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-29
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care