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PMK MEDICAL GROUP INC. NPI 1962405860


NPI Information

NPI: 1962405860
Provider Name: PMK MEDICAL GROUP, INC.

Doing Business As: VENTURA COUNTY HEMATOLOGY ONCOLOGY SPECIALISTS

Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

CLIA Number: 05D1086245

Address:
1700 N ROSE AVE STE 320
OXNARD, CA
ZIP 93030
Phone: (805) 485-8709
Get Directions

PMK MEDICAL GROUP, INC. is a hematology and oncology internal medicine in Oxnard, CA. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. PMK MEDICAL GROUP, INC. NPI is 1962405860. The provider is registered as an organization entity type.
The provider Is Doing Business As Ventura County Hematology Oncology Specialists.

The provider's business location address is:

1700 N ROSE AVE STE 320
OXNARD, CA
ZIP 93030-648
Phone: (805) 485-8709
Fax: (805) 485-5521

The provider's authorized official is Marissa Rivera .
The authorized official title is Finance & Quality Officer and has the following contact phone number (805) 485-8709.

The CLIA number assigned to this NPI record is 05D1086245 - other practitioner with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 5/24/2005 and was last updated on 8/6/2021.


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
1261QX0200XClinic/CenterOncologyNo
2207RH0003XInternal MedicineHematology & OncologyYes

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
1ZZZ45387ZOTHERCALIFORNIABLUE SHIELD PROVIDER
25628497OTHERCALIFORNIANCPDP/NPDS
3W13337OTHERMEDICARE PTAN
4GR0064440MEDICAIDCALIFORNIA

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

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