Provider Demographics
NPI:1366498917
Name:JUROW, RONNA (MD)
Entity Type:Individual
Prefix:DR
First Name:RONNA
Middle Name:
Last Name:JUROW
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 1:100 N BRENT ST
Mailing Address - Street 2:#103
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2822
Mailing Address - Country:US
Mailing Address - Phone:805-643-1114
Mailing Address - Fax:805-643-4038
Practice Address - Street 1:100 N BRENT ST
Practice Address - Street 2:#103
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2822
Practice Address - Country:US
Practice Address - Phone:805-643-1114
Practice Address - Fax:805-643-4038
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG40091207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA89695Medicare UPIN
CAG40091Medicare ID - Type Unspecified