Healthcare Provider Details

I. General information

NPI: 1033357736
Provider Name (Legal Business Name): CALIFORNIA HEALTHFIRST PHYSICIANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2009
Last Update Date: 09/11/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5051 VERDUGO WAY SUITE 110
CAMARILLO CA
93012-8680
US

IV. Provider business mailing address

PO BOX 10968
SAN BERNARDINO CA
92423-0968
US

V. Phone/Fax

Practice location:
  • Phone: 805-445-7010
  • Fax: 805-484-3610
Mailing address:
  • Phone: 909-335-7171
  • Fax: 909-335-7140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

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