Provider Demographics
NPI:1689975443
Name:KOLAR N. MURTHY, M.D., INC.
Entity Type:Organization
Organization Name:KOLAR N. MURTHY, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KOLAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MURTHY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-495-6702
Mailing Address - Street 1:2220 LYNN RD STE 300
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-8041
Mailing Address - Country:US
Mailing Address - Phone:805-495-6702
Mailing Address - Fax:805-495-6195
Practice Address - Street 1:2220 LYNN RD STE 300
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-8041
Practice Address - Country:US
Practice Address - Phone:805-495-6702
Practice Address - Fax:805-495-6195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-10
Last Update Date:2010-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA251762084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A251760Medicaid
CA00A251760Medicaid