Provider Demographics
NPI:1669634101
Name:HARGETT, DAMAYEA ISATU (MD)
Entity Type:Individual
Prefix:
First Name:DAMAYEA
Middle Name:ISATU
Last Name:HARGETT
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 1:2323 KNOLL DR
Mailing Address - Street 2:SUITE 219
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7307
Mailing Address - Country:US
Mailing Address - Phone:805-652-6139
Mailing Address - Fax:
Practice Address - Street 1:133 W SANTA CLARA ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-2543
Practice Address - Country:US
Practice Address - Phone:805-641-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA111876207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery