Healthcare Provider Details
I. General information
NPI: 1669940003
Provider Name (Legal Business Name): BUENA MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/03/2018
Last Update Date: 02/16/2024
Certification Date: 02/16/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
905 S A ST STE 1
OXNARD CA
93030-9253
US
IV. Provider business mailing address
905 S A ST STE 1
OXNARD CA
93030-9253
US
V. Phone/Fax
- Phone: 805-487-9150
- Fax: 805-487-9152
- Phone: 805-487-9150
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NARESH
R
PATEL
Title or Position: PRESIDENT
Credential: MD
Phone: 714-915-5779