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EASTERN VENTURA MEDICAL GROUP INC. NPI 1417900788


NPI Information

NPI: 1417900788
Provider Name: EASTERN VENTURA MEDICAL GROUP, INC.

Doing Business As: MED CENTER MEDICAL CENTER

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D0584090

Address:
1980 SEQUOIA AVE
SIMI VALLEY, CA
ZIP 93063
Phone: (805) 583-5555
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EASTERN VENTURA MEDICAL GROUP, INC. is a family medicine in Simi Valley, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. EASTERN VENTURA MEDICAL GROUP, INC. NPI is 1417900788. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Med Center Medical Center.

The provider's business location address is:

1980 SEQUOIA AVE
SIMI VALLEY, CA
ZIP 93063-167
Phone: (805) 583-5555
Fax: (805) 583-5554

The provider's authorized official is Denice Ruscigno .
The authorized official title is Administrator and has the following contact phone number (805) 583-5555.

The CLIA number assigned to this NPI record is 05D0584090 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/18/2006 and was last updated on 7/2/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine=========CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.