Provider Demographics
NPI:1821120312
Name:OCEAN VIEW SPECIALISTS
Entity Type:Organization
Organization Name:OCEAN VIEW SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROJAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-973-0146
Mailing Address - Street 1:13624 HAWTHORNE BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:CA
Mailing Address - Zip Code:90250-5818
Mailing Address - Country:US
Mailing Address - Phone:310-973-0146
Mailing Address - Fax:
Practice Address - Street 1:13624 HAWTHORNE BLVD STE 201
Practice Address - Street 2:
Practice Address - City:HAWTHORNE
Practice Address - State:CA
Practice Address - Zip Code:90250-5818
Practice Address - Country:US
Practice Address - Phone:310-973-0146
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA41262174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A412620Medicaid
CAGR0041361Medicaid
CAW10513AMedicare ID - Type Unspecified
CAGR0041361Medicaid