MEDICARE: VENTURA ORTHOPEDICS MEDICAL GROUP, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1417580325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VENTURA ORTHOPEDICS MEDICAL GROUP, INC.

Provider Business Mailing Address
First Line	:	1203 FLYNN RD UNIT 160
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93012-6203
Country	:	US
Telephone Number	:	805-804-4168
Fax Number	:	805-830-1177

Provider Business Practice Location Address
First Line	:	1145 LINDERO CANYON RD STE C1
Second Line	:
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91362-5475
Country	:	US
Telephone Number	:	818-865-9800
Fax Number	:	818-330-5332

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MINERVA BUTLER
Credential	:
Telephone Number	:	805-941-0056

Provider Enumeration Date	:	02/19/2020
Last Update Date	:	01/07/2026

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