MR. MICHAEL SCOTT MORTENSEN PHYSICIAN ASSISTANT
NPI 1124671532
Physician Assistant - Medical in Thousand Oaks, CA

Active since July 24, 2019
425 HAALAND DR STE 102, THOUSAND OAKS, CA 91361(805) 723-8008 Get Directions Write a Review

NPPES record last updated: July 24, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Michael Scott Mortensen Physician Assistant NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. MICHAEL SCOTT MORTENSEN PHYSICIAN ASSISTANT (NPI 1124671532) is an individual medical provider in Thousand Oaks, California, licensed in California (56485) and active in the NPI registry since July 2019.

NPPES Registry Identity

NPI1124671532
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. MICHAEL SCOTT MORTENSENCredential: PHYSICIAN ASSISTANT
Location Address425 HAALAND DR STE 102Thousand Oaks, CA 91361-5230
Mailing Address3713 Corte De Los ReyesThousand Oaks, CA 91360-7025 · (805) 529-3475
Sole ProprietorNo
Enumeration DateJuly 24, 2019
NPI 1124671532 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in CA · 56485
425 HAALAND DR STE 102, Thousand Oaks, CA 91361

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Michael Mortensen's NPI number?

The NPI number for Michael Mortensen is 1124671532. It was assigned to this individual provider in the NPPES registry on July 24, 2019.

Where is Michael Mortensen located?

Michael Mortensen practices at 425 Haaland Dr Ste 102, Thousand Oaks, CA 91361. The listed phone number is (805) 723-8008.

What is Michael Mortensen's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Michael Mortensen was last updated on July 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.