Provider Demographics
NPI:1669634028
Name:OHEVSHALOM, DINA (DO)
Entity Type:Individual
Prefix:MRS
First Name:DINA
Middle Name:
Last Name:OHEVSHALOM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2230 LYNN ROAD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-1900
Mailing Address - Country:US
Mailing Address - Phone:805-495-1066
Mailing Address - Fax:805-230-9265
Practice Address - Street 1:2230 LYNN ROAD
Practice Address - Street 2:SUITE 200
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-1900
Practice Address - Country:US
Practice Address - Phone:805-495-1066
Practice Address - Fax:805-497-0162
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2014-01-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY261336207Q00000X
CA20A12697207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine