Healthcare Provider Details
I. General information
NPI: 1861707770
Provider Name (Legal Business Name): WEST COAST CRITICAL CARE SPECIALISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/16/2010
Last Update Date: 11/24/2020
Certification Date: 11/24/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1910 OUTLET CENTER DR
OXNARD CA
93036
US
IV. Provider business mailing address
1910 OUTLET CENTER DR
OXNARD CA
93036-0677
US
V. Phone/Fax
- Phone: 805-485-2400
- Fax: 805-485-2455
- Phone: 805-485-2400
- Fax: 805-485-2455
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0200X |
| Taxonomy | Critical Care Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RP1001X |
| Taxonomy | Pulmonary Disease Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RS0012X |
| Taxonomy | Sleep Medicine (Internal Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RAJAN
BHATIA
Title or Position: OWNER/CEO
Credential: M.D.
Phone: 805-485-2400