Provider Demographics
NPI:1013065457
Name:CAL OAKS THERAPY CENTER
Entity type:Organization
Organization Name:CAL OAKS THERAPY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ILISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DULUC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-425-7622
Mailing Address - Street 1:24355 LYONS AVE
Mailing Address - Street 2:STE 216
Mailing Address - City:NEWHALL
Mailing Address - State:CA
Mailing Address - Zip Code:91321
Mailing Address - Country:US
Mailing Address - Phone:661-425-7622
Mailing Address - Fax:661-425-7624
Practice Address - Street 1:24355 LYONS AVE
Practice Address - Street 2:STE 216
Practice Address - City:NEWHALL
Practice Address - State:CA
Practice Address - Zip Code:91321
Practice Address - Country:US
Practice Address - Phone:661-425-7622
Practice Address - Fax:661-425-7624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA054550Medicare Oscar/Certification