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General NPI Number Information
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NPI Number | 1710219662
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Entity Type | Organization
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Legal Business Name | VENTURA EYE INSTITUTE, INC
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Dates
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Enumeration Date | 02/03/2010
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Last Update Date | 04/20/2017
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Provider Practice Location Address
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Address Line | 3801 LAS POSAS RD SUITE 112
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City | CAMARILLO
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State | CA
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Zip | 93010-1427
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Country | US
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Telephone | 805-388-1211
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Fax | 805-388-0900
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Provider Business Mailing Address
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Address Line | 3801 LAS POSAS RD SUITE 112
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City | CAMARILLO
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State | CA
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Zip | 93010-1427
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Country | US
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Telephone | 805-388-1211
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Fax | 805-388-0900
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Authorized Official
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Title or Position | PROVIDER
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Name | MICHAEL T RAGEN
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Credential | M.D.
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Telephone | 805-388-1211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | CA
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