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General NPI Number Information
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NPI Number | 1417970849
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Entity Type | Organization
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Legal Business Name | PRIMARY MEDICAL GROUP OF VENTURA COUNTY INC
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 2772 JOHNSON DR STE 200
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City | VENTURA
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State | CA
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Zip | 93003-7262
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Country | US
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Telephone | 805-642-1430
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Fax | 833-916-2135
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Provider Business Mailing Address
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Address Line | 26 S GARDEN ST STE 1
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City | VENTURA
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State | CA
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Zip | 93001-4521
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Country | US
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Telephone | 805-507-2225
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Fax | 805-642-1436
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Authorized Official
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Title or Position | VP REVENUE CYCLE, CREDENTIALING
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Name | DENISE CAIN
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Credential |
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Telephone | 951-677-4193
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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