Healthcare Provider Details

I. General information

NPI: 1689500936
Provider Name (Legal Business Name): NATHAN WHITING CPO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4517 MARKET ST STE 4
VENTURA CA
93003-7841
US

IV. Provider business mailing address

4517 MARKET ST STE 4
VENTURA CA
93003-7841
US

V. Phone/Fax

Practice location:
  • Phone: 805-658-1822
  • Fax:
Mailing address:
  • Phone: 805-658-1822
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code222Z00000X
TaxonomyOrthotist
License NumberCPO04058
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code224P00000X
TaxonomyProsthetist
License NumberCPO04058
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: