Provider Demographics
NPI:1811027501
Name:OJAI HEALTHCARE LLC
Entity Type:Organization
Organization Name:OJAI HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:MOAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-646-8124
Mailing Address - Street 1:601 N MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-2751
Mailing Address - Country:US
Mailing Address - Phone:805-646-8124
Mailing Address - Fax:805-646-2627
Practice Address - Street 1:601 N MONTGOMERY ST
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-2751
Practice Address - Country:US
Practice Address - Phone:805-646-8124
Practice Address - Fax:805-646-2627
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA050000020282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1265515118Medicaid
CALTC05861HMedicaid
CA1265515118Medicaid