Healthcare Provider Details

I. General information

NPI: 1053941336
Provider Name (Legal Business Name): KEVIN VERA DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2020
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 SOLAR DR STE 102
OXNARD CA
93036-0649
US

IV. Provider business mailing address

2100 SOLAR DR STE 102
OXNARD CA
93036-0649
US

V. Phone/Fax

Practice location:
  • Phone: 808-988-3338
  • Fax: 805-830-1537
Mailing address:
  • Phone: 808-988-3338
  • Fax: 805-830-1537

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberE6167
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberE6167
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: