Healthcare Provider Details

I. General information

NPI: 1750497400
Provider Name (Legal Business Name): JOHN A HANDLEY III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 NORTH BRENT STREET SUITE 406
VENTURA CA
93003-2824
US

IV. Provider business mailing address

168 NORTH BRENT STREET SUITE 406
VENTURA CA
93003-2824
US

V. Phone/Fax

Practice location:
  • Phone: 805-653-6371
  • Fax: 805-653-7242
Mailing address:
  • Phone: 805-653-6371
  • Fax: 805-653-7242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberG46618
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberG46618
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: