Provider Demographics
NPI:1497343263
Name:VENTURA COUNTY CENTER FOR REGENERATIVE MEDICINE INC.
Entity Type:Organization
Organization Name:VENTURA COUNTY CENTER FOR REGENERATIVE MEDICINE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:DOOMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:805-484-1077
Mailing Address - Street 1:4087 MISSION OAKS BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-5156
Mailing Address - Country:US
Mailing Address - Phone:805-419-4234
Mailing Address - Fax:
Practice Address - Street 1:4087 MISSION OAKS BLVD STE B
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-5156
Practice Address - Country:US
Practice Address - Phone:805-419-4234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOOMAN CHIROPRACTIC CLINIC, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty