Most Relevant Information
Provider Data
| NPI Number: | 1003224320 |
| Provider Name: | DAMIANO IMPASTATO |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 07/30/2014 |
| Last Updated: | 07/30/2014 |
Provider Practice Location
1750 S LEWIS RD
CAMARILLO
CA
930128520
Practice Location Phone/Fax
| Phone: | 8057659050 |
| Fax: |
Provider Mailing Location
28915 THOUSAND OAKS BLVD
UNIT 285
AGOURA HILLS
CA
913012136
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |