Healthcare Provider Details

I. General information

NPI: 1194910422
Provider Name (Legal Business Name): AUGUSTO FOCIL M D A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 10/17/2025
Certification Date: 10/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S A ST STE 105
OXNARD CA
93030-5841
US

IV. Provider business mailing address

300 S A ST STE 105
OXNARD CA
93030-5841
US

V. Phone/Fax

Practice location:
  • Phone: 805-486-6565
  • Fax: 805-486-0740
Mailing address:
  • Phone: 805-486-6565
  • Fax: 805-486-0740

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 Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberA44207
License Number StateCA

VIII. Authorized Official

Name: MARTHA BENAVIDES
Title or Position: ADMINISTRATOR
Credential:
Phone: 805-486-6565