Provider Demographics
NPI:1114637527
Name:EAR NOSE THROAT OF OJAI PC
Entity Type:Organization
Organization Name:EAR NOSE THROAT OF OJAI PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TOM
Authorized Official - Middle Name:KENDALL
Authorized Official - Last Name:COFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-400-2608
Mailing Address - Street 1:1301 MARICOPA HWY STE B
Mailing Address - Street 2:
Mailing Address - City:OJAI
Mailing Address - State:CA
Mailing Address - Zip Code:93023-3130
Mailing Address - Country:US
Mailing Address - Phone:203-400-2608
Mailing Address - Fax:
Practice Address - Street 1:1301 MARICOPA HWY STE B
Practice Address - Street 2:
Practice Address - City:OJAI
Practice Address - State:CA
Practice Address - Zip Code:93023-3130
Practice Address - Country:US
Practice Address - Phone:203-400-2608
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-28
Last Update Date:2022-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty