Healthcare Provider Details

I. General information

NPI: 1376641449
Provider Name (Legal Business Name): CARDIOLOGY ASSOCIATES MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N BRENT ST STE 301
VENTURA CA
93003-2836
US

IV. Provider business mailing address

100 N BRENT ST STE 301
VENTURA CA
93003-2836
US

V. Phone/Fax

Practice location:
  • Phone: 805-653-0101
  • Fax: 805-641-0434
Mailing address:
  • Phone: 805-653-0101
  • Fax: 805-643-6285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. PHIL JANKE
Title or Position: CHIEF OPERATING OFFICER
Credential: MBA
Phone: 805-275-4590