MEDICARE: DR. PATRICK DIESFELD M.D.

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	207V00000X	Obstetrics & Gynecology Physician	G48770	CA

General Provider Information

NPI Number	:	1568576080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK DIESFELD M.D.

Provider Business Mailing Address
First Line	:	168 N BRENT ST STE 407
Second Line	:
City	:	VENTURA
State	:	CA
Zip	:	93003-2824
Country	:	US
Telephone Number	:	805-648-2717
Fax Number	:	805-648-2023

Provider Business Practice Location Address
First Line	:	168 N BRENT ST STE 407
Second Line	:
City	:	VENTURA
State	:	CA
Zip	:	93003-2824
Country	:	US
Telephone Number	:	805-648-2717
Fax Number	:	805-648-2023

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2006
Last Update Date	:	10/30/2025

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