Healthcare Provider Details

I. General information

NPI: 1235866138
Provider Name (Legal Business Name): CLINICAS DEL CAMINO REAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2022
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 STATHAM BLVD
OXNARD CA
93033
US

IV. Provider business mailing address

2100 STATHAM BLVD
OXNARD CA
93033
US

V. Phone/Fax

Practice location:
  • Phone: 805-659-1750
  • Fax: 805-656-9959
Mailing address:
  • Phone: 805-330-8680
  • Fax: 805-728-1428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FARHAD BENHARASH
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 805-659-1740