MEDICARE: MJV HEALTH CARE CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	315P00000X	Intellectual Disabilities Intermediate Care Facility	050000346	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710951652
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MJV HEALTH CARE CORP

Provider Business Mailing Address
First Line	:	981 GILL AVE
Second Line	:
City	:	PORT HUENEME
State	:	CA
Zip	:	93041
Country	:	US
Telephone Number	:	805-487-7953
Fax Number	:	805-487-9757

Provider Business Practice Location Address
First Line	:	981 GILL AVE
Second Line	:
City	:	PORT HUENEME
State	:	CA
Zip	:	93041
Country	:	US
Telephone Number	:	805-487-7953
Fax Number	:	805-487-9757

Authorized Official
Title or Position	:	ASST. ADMINISTRATOR
Name	:	NORMA A. VELASCO
Credential	:
Telephone Number	:	805-487-9757

Provider Enumeration Date	:	02/15/2006
Last Update Date	:	11/14/2008

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Directions to “MJV HEALTH CARE CORP ” Practice Location

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