Healthcare Provider Details

I. General information

NPI: 1841256427
Provider Name (Legal Business Name): OJAI VALLEY FAMILY MEDICINE GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2006
Last Update Date: 12/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 PIRIE RD SUITE D
OJAI CA
93023-3166
US

IV. Provider business mailing address

117 PIRIE RD SUITE D
OJAI CA
93023-3166
US

V. Phone/Fax

Practice location:
  • Phone: 805-646-7246
  • Fax: 805-646-8936
Mailing address:
  • Phone: 805-646-7246
  • Fax: 805-646-8936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG35542
License Number StateCA

VIII. Authorized Official

Name: MRS. BONNIE J LANDSMAN
Title or Position: OFFICE MANAGER
Credential:
Phone: 805-646-7246