Healthcare Provider Details

I. General information

NPI: 1376689786
Provider Name (Legal Business Name): RONALD H CHOCHINOV MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 11/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 NORTH BRENT #405
VENTURA CA
93003-2824
US

IV. Provider business mailing address

168 NORTH BRENT SUITE 405
VENTURA CA
93003-2824
US

V. Phone/Fax

Practice location:
  • Phone: 805-667-3909
  • Fax: 805-667-3915
Mailing address:
  • Phone: 805-667-3909
  • Fax: 805-667-3915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberC37820
License Number StateCA

VIII. Authorized Official

Name: DR. RONALD H CHOCHINOV
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 805-667-3909