Healthcare Provider Details

I. General information

NPI: 1891322459
Provider Name (Legal Business Name): MANASI C GHATGE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 LOMA VISTA RD STE 205
VENTURA CA
93003-2909
US

IV. Provider business mailing address

5855 OLIVAS PARK DR
VENTURA CA
93003-7672
US

V. Phone/Fax

Practice location:
  • Phone: 805-642-4830
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA185309
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: