Healthcare Provider Details

I. General information

NPI: 1891836615
Provider Name (Legal Business Name): BUENA VIDA MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W PLEASANT VALLEY RD
OXNARD CA
93033-7626
US

IV. Provider business mailing address

311 N ROBERTSON BLVD # 692
BEVERLY HILLS CA
90211-1705
US

V. Phone/Fax

Practice location:
  • Phone: 805-247-0708
  • Fax: 805-247-0508
Mailing address:
  • Phone: 805-247-0708
  • Fax: 805-247-0508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberG37804
License Number StateCA

VIII. Authorized Official

Name: DR. JOHN CUDE
Title or Position: VICE PRESIDENT
Credential: DPM
Phone: 805-247-0708