Provider Demographics
NPI:1477746642
Name:VENTURA MED INC
Entity Type:Organization
Organization Name:VENTURA MED INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-644-6337
Mailing Address - Street 1:3737 TELEGRAPH RD STE E
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3464
Mailing Address - Country:US
Mailing Address - Phone:805-644-6337
Mailing Address - Fax:805-644-6331
Practice Address - Street 1:3737 TELEGRAPH RD STE E
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3464
Practice Address - Country:US
Practice Address - Phone:805-644-6337
Practice Address - Fax:805-644-6331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47068332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5958500001Medicare NSC