Provider Demographics
NPI:1417210600
Name:DAMAGHI, NIUSHA (MD)
Entity Type:Individual
Prefix:DR
First Name:NIUSHA
Middle Name:
Last Name:DAMAGHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 OUTLET CENTER DR
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-0677
Mailing Address - Country:US
Mailing Address - Phone:805-485-2400
Mailing Address - Fax:805-485-3025
Practice Address - Street 1:ST. JOHN'S REGIONAL MEDICAL CENTER - 1600 N ROSE AVENUE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-9303
Practice Address - Country:US
Practice Address - Phone:000-000-0000
Practice Address - Fax:805-485-3025
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-21
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT202538207R00000X
CAA136919207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease