Provider Demographics
NPI:1104203314
Name:COUNTY OF VENTURA
Entity Type:Organization
Organization Name:COUNTY OF VENTURA
Other - Org Name:MARIPOSA URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HEALTH CARE AGENCY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHNSON
Authorized Official - Middle Name:
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-677-5272
Mailing Address - Street 1:800 S VICTORIA AVE # L4615
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93009-0003
Mailing Address - Country:US
Mailing Address - Phone:805-677-5210
Mailing Address - Fax:
Practice Address - Street 1:3801 LAS POSAS RD
Practice Address - Street 2:SUITE 106B
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-1427
Practice Address - Country:US
Practice Address - Phone:805-477-2300
Practice Address - Fax:805-477-2301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-27
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care