Provider Demographics
NPI:1427738939
Name:FRIZZY OAKS MEDICAL GROUP INC
Entity type:Organization
Organization Name:FRIZZY OAKS MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:RONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JUROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-340-2995
Mailing Address - Street 1:14545 FRIAR ST STE 217
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411-2399
Mailing Address - Country:US
Mailing Address - Phone:818-851-5531
Mailing Address - Fax:
Practice Address - Street 1:14545 FRIAR ST STE 217
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411-2399
Practice Address - Country:US
Practice Address - Phone:818-851-5531
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty