Provider Demographics
NPI:1396910915
Name:DAVID GHAUSI DO INC
Entity type:Organization
Organization Name:DAVID GHAUSI DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GHAUSI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:805-497-0244
Mailing Address - Street 1:2220 LYNN RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-1904
Mailing Address - Country:US
Mailing Address - Phone:805-497-0244
Mailing Address - Fax:805-497-0844
Practice Address - Street 1:325 S MOORPARK RD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-1008
Practice Address - Country:US
Practice Address - Phone:805-497-0244
Practice Address - Fax:805-497-0844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-24
Last Update Date:2025-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8764207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5652438Medicaid