1821253402 NPI number — COUNTY OF VENTURA

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821253402 NPI number — COUNTY OF VENTURA

Employer Identification Number (EIN):

Provider Organization Name:

COUNTY OF VENTURA

Provider Last Name:

Provider First Name:

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

Provider Gender Code:

Provider Other Organization Name:

VENTURA COUNTY MEDICAL CENTER

Provider Other Organization Name Type Code:

3

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1821253402

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

01/15/2019

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

800 S VICTORIA AVE # 4615

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

VENTURA

Provider Business Mailing Address State Name:

CA

Provider Business Mailing Address Postal Code:

93009-0003

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

805-648-9562

Provider Business Mailing Address Fax Number:

805-648-9561

Provider First Line Business Practice Location Address:

300 HILLMONT AVE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

VENTURA

Provider Business Practice Location Address State Name:

CA

Provider Business Practice Location Address Postal Code:

93003-1651

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

805-652-6000

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

07/23/2008

Authorized Official Last Name:

MILSTIEN

Authorized Official First Name:

KIM

Authorized Official Middle Name:

Authorized Official Title or Position:

CHIEF DEPUTY DIRECTOR

Authorized Official Telephone Number:

805-652-6058

• Taxonomy code: 261Q00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 261QF0050X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 261QI0500X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 261QM0801X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 261QM0850X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 261QM0855X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 261QM1300X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 261QM2500X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 261QP0905X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 261QP2000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 261QP2300X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 261QR0200X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 261QR0206X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 261QU0200X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 282N00000X , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: LAB58856F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
• Identifier: ZZT39008W , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
• Identifier: ZZT49004F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
• Identifier: ZZT39008F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
• Identifier: 025553 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
• Identifier: 187047 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".
• Identifier: 3004405 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
• Identifier: GR0072000 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
• Identifier: HSC39008W , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
• Identifier: HSD39008F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
• Identifier: GR0072001 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
• Identifier: HSC39008F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
• Identifier: LAB01063F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".
• Identifier: ZZT49008F , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".