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General NPI Number Information
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NPI Number | 1104865518
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Entity Type | Organization
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Legal Business Name | COMMUNITY MEMORIAL HEALTH SYSTEM
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 05/19/2025
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Provider Practice Location Address
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Address Line | 422 ARNEILL RD SUITE B
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City | CAMARILLO
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State | CA
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Zip | 93010-6439
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Country | US
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Telephone | 805-482-1282
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Fax | 805-383-4511
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Provider Business Mailing Address
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Address Line | 5855 OLIVAS PARK DR
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City | VENTURA
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State | CA
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Zip | 93003-7672
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Country | US
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Telephone | 805-667-2801
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Fax | 805-667-2865
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Authorized Official
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Title or Position | CEO
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Name | MR. MICK ZDEBLICK
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Credential |
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Telephone | 805-652-5011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QV0200X
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Taxonomy Name | VA Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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