MEDICARE: DR. JOHN A HANDLEY III MD

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	G46618	CA
2	207RP1001X	Pulmonary Disease Physician	G46618	CA

General Provider Information

NPI Number	:	1750497400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN A HANDLEY III MD

Provider Business Mailing Address
First Line	:	168 NORTH BRENT STREET
Second Line	:	SUITE 406
City	:	VENTURA
State	:	CA
Zip	:	93003-2824
Country	:	US
Telephone Number	:	805-653-6371
Fax Number	:	805-653-7242

Provider Business Practice Location Address
First Line	:	168 NORTH BRENT STREET
Second Line	:	SUITE 406
City	:	VENTURA
State	:	CA
Zip	:	93003-2824
Country	:	US
Telephone Number	:	805-653-6371
Fax Number	:	805-653-7242

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

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	09/11/2025

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