Healthcare Provider Details

I. General information

NPI: 1902305550
Provider Name (Legal Business Name): WENDY WARWAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2018
Last Update Date: 02/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

451 W GONZALES RD STE 130
OXNARD CA
93036-0721
US

IV. Provider business mailing address

397 SAN FRANCISCO AVE
VENTURA CA
93004-1180
US

V. Phone/Fax

Practice location:
  • Phone: 805-981-7691
  • Fax: 805-981-7676
Mailing address:
  • Phone: 805-981-7691
  • Fax: 805-981-7676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA50733
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: