Healthcare Provider Details

I. General information

NPI: 1033399415
Provider Name (Legal Business Name): CALIFORNIA HEALTHFIRST PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2007
Last Update Date: 11/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5051 VERDUGO WAY STE 100
CAMARILLO CA
93012-8681
US

IV. Provider business mailing address

PO BOX 10968
SAN BERNARDINO CA
92423-0968
US

V. Phone/Fax

Practice location:
  • Phone: 805-384-8071
  • Fax: 805-987-1927
Mailing address:
  • Phone: 909-335-7171
  • Fax: 909-335-7140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP17104
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberNMW1008
License Number StateCA
# 5
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: LISA PERKO
Title or Position: CFO
Credential:
Phone: 909-335-7171