Healthcare Provider Details

I. General information

NPI: 1558681759
Provider Name (Legal Business Name): AVNEET VATS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 06/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2738 E THOMPSON BLVD
VENTURA CA
93003-2719
US

IV. Provider business mailing address

2738 E THOMPSON BLVD
VENTURA CA
93003-2719
US

V. Phone/Fax

Practice location:
  • Phone: 805-648-7795
  • Fax:
Mailing address:
  • Phone: 805-648-7795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number62472
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: