Provider Demographics
NPI:1184648933
Name:BILLESDON, JOHN C (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:C
Last Name:BILLESDON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2241 WANKEL WAY
Mailing Address - Street 2:STE. A.
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-0190
Mailing Address - Country:US
Mailing Address - Phone:805-983-0521
Mailing Address - Fax:805-983-4186
Practice Address - Street 1:2241 WANKEL WAY
Practice Address - Street 2:STE. A.
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-0190
Practice Address - Country:US
Practice Address - Phone:805-983-0521
Practice Address - Fax:805-983-4186
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG22785207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA41717Medicare UPIN
CAW2289Medicare ID - Type Unspecified