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1124671532
MICHAEL SCOTT MORTENSEN
THOUSAND OAKS, CA
NPI
1124671532
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: CA 56485)
Enumeration Date
2019-07-24
Last Update Date
2019-07-24
Business Address
Mr. MICHAEL SCOTT MORTENSEN Physician Assistant
425 HAALAND DR STE 102
THOUSAND OAKS, CA 91361-5230
Phone number: 805-723-8008
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Mailing Address
Mr. MICHAEL SCOTT MORTENSEN Physician Assistant
3713 CORTE DE LOS REYES
THOUSAND OAKS, CA 91360-7025
Phone number: 805-529-3475
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