Provider Demographics
NPI:1033146873
Name:GARG, USHA (MD)
Entity Type:Individual
Prefix:
First Name:USHA
Middle Name:
Last Name:GARG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25420
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93002-2277
Mailing Address - Country:US
Mailing Address - Phone:805-650-5910
Mailing Address - Fax:805-650-5972
Practice Address - Street 1:1600 N ROSE AVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-3722
Practice Address - Country:US
Practice Address - Phone:805-988-2708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32079207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1376601393OtherGROUP NPI
CA00A320790Medicaid
CA220012461OtherRAILROAD MEDICARE
CAGR0059650Medicaid
CAA32079OtherMEDICAL BOARAD OF CALIFOR
HW8241AMedicare PIN
CAA32079OtherMEDICAL BOARAD OF CALIFOR
CAGR0059650Medicaid
CAHW8241Medicare PIN