CHANNEL ISLAND OBSTETRICS AND GYNECOLOGIC MEDICAL GROUP NPI 1598754780

NPI Information

  • NPI: 1598754780
  • Provider Name: CHANNEL ISLAND OBSTETRICS AND GYNECOLOGIC MEDICAL GROUP
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Organization
  • CLIA Number: 05D0969454
  • Address: 2486 PONDEROSA DR NORTH STE D202
    CAMARILLO, CA
    ZIP 93010
  • Phone: (805) 482-4641

Map and Directions

Get Directions

NPI Details

CHANNEL ISLAND OBSTETRICS AND GYNECOLOGIC MEDICAL GROUP is an obstetrics gynecology in Camarillo, CA. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. CHANNEL ISLAND OBSTETRICS AND GYNECOLOGIC MEDICAL GROUP NPI is 1598754780. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2486 PONDEROSA DR NORTH STE D202
CAMARILLO, CA
ZIP 93010
Phone: (805) 482-4641
Fax: (805) 388-8751

The provider's authorized official is Stephen P. Carter .
The authorized official title is General Partner/physician and has the following contact phone number (805) 482-4641.

The CLIA number assigned to this NPI record is 05D0969454 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/19/2005 and was last updated on 7/21/2022.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & GynecologyNo
2207V00000XObstetrics & GynecologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1GR0087730MEDICAIDCALIFORNIA

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: 3/30/2025

NPI Synchronization or Removal

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.

Previous NPI
Next NPI