Healthcare Provider Details
I. General information
NPI: 1003836545
Provider Name (Legal Business Name): BUENA VISTA FAMILY MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/20/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
719 N A ST
OXNARD CA
93030-4309
US
IV. Provider business mailing address
719 N A ST
OXNARD CA
93030-4309
US
V. Phone/Fax
- Phone: 805-485-9123
- Fax:
- Phone: 805-485-9123
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | A56329 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | A56329 |
| License Number State | CA |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2300X |
| Taxonomy | Primary Care Clinic/Center |
| License Number | A56329 |
| License Number State | CA |
VIII. Authorized Official
Name: DR.
RICHARD
X
NGUYEN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 805-485-9123