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General NPI Number Information
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NPI Number | 1598704421
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Entity Type | Organization
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Legal Business Name | VENTURA COUNTY UROLOGY MEDICAL GROUP, INC
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 06/07/2011
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Provider Practice Location Address
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Address Line | 2807 LOMA VISTA RD #101
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City | VENTURA
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State | CA
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Zip | 93003-1500
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Country | US
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Telephone | 805-653-1533
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Fax | 805-653-1536
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Provider Business Mailing Address
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Address Line | 2807 LOMA VISTA RD #101
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City | VENTURA
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State | CA
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Zip | 93003-1500
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Country | US
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Telephone | 805-653-1533
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Fax | 805-653-1536
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CEDRIC B EMERY
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Credential | M.D.
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Telephone | 805-653-1533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | G13489
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License Number State | CA
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