Healthcare Provider Details

I. General information

NPI: 1083751200
Provider Name (Legal Business Name): CHANNEL ISLANDS FAMILY MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 S VENTURA RD
OXNARD CA
93033-4905
US

IV. Provider business mailing address

2800 S VENTURA RD
OXNARD CA
93033-4905
US

V. Phone/Fax

Practice location:
  • Phone: 805-984-0144
  • Fax: 805-487-7445
Mailing address:
  • Phone: 805-984-0144
  • Fax: 805-487-7445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License NumberFNP13657
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA35301
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA35200
License Number StateCA

VIII. Authorized Official

Name: DR. PADUVILAN C NARAYANAN
Title or Position: PARTNER
Credential: M.D,
Phone: 805-984-0144