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VISTA DEL MAR MEDICAL GROUP INC NPI 1942239694


NPI Information

NPI: 1942239694
Provider Name: VISTA DEL MAR MEDICAL GROUP, INC

Other Name: N/A

Classification: Internal Medicine - 207RN0300X
Entity Type: Organization

Specialization: Nephrology

CLIA Number: 05D2108302

Address:
1200 W GONZALES RD
SUITE 300
OXNARD, CA
ZIP 93036
Phone: (805) 983-0691
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VISTA DEL MAR MEDICAL GROUP, INC is a nephrology internal medicine in Oxnard, CA. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. VISTA DEL MAR MEDICAL GROUP, INC NPI is 1942239694. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is N/a.

The provider's business location address is:

1200 W GONZALES RD
SUITE 300
OXNARD, CA
ZIP 93036-072
Phone: (805) 983-0691
Fax: (805) 981-1643

The provider's authorized official is Richard K Westerdoll .
The authorized official title is Executive Director and has the following contact phone number (805) 983-0691.

The CLIA number assigned to this NPI record is 05D2108302 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/2/2006 and was last updated on 11/12/2021.


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
1207R00000XInternal MedicineFNP4189CALIFORNIANo
2207RN0300XInternal MedicineNephrologyFNP4189CALIFORNIAYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1ZZZ34679ZOTHERCALIFORNIABLUE CROSS
2110039977OTHERCALIFORNIAMEDICARE RAILROAD
3ZZZ75566ZMEDICAIDCALIFORNIA

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.