Healthcare Provider Details

I. General information

NPI: 1083898142
Provider Name (Legal Business Name): MNS MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2007
Last Update Date: 04/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3291 LOMA VISTA RD
VENTURA CA
93003-3099
US

IV. Provider business mailing address

3418 LOMA VISTA RD STE A
VENTURA CA
93003-3015
US

V. Phone/Fax

Practice location:
  • Phone: 805-642-8565
  • Fax: 805-642-8564
Mailing address:
  • Phone: 805-642-8565
  • Fax: 805-642-8564

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: MAGALY CHAVEZ
Title or Position: OFFICE MGR
Credential:
Phone: 805-642-8565