Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Michael Scott Mortensen, PHYSICIANASSISTANT

Individual provider Medical Physician Assistant · NPI 1124671532

Mr. Michael Scott Mortensen, PHYSICIANASSISTANT is a Medical Physician Assistant in Thousand Oaks, California. Licensed in California. Registered with an NPI since 2019.

Licensed in
CA
In the registry since
2019

Practice location Address checks out

425 Haaland Dr Ste 102
Thousand Oaks, CA 91361-5230
Phone: (805) 723-8008
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 56485 (CA)

Record details

NPI number1124671532
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedJuly 24, 2019
Last updated in NPPESJuly 24, 2019

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