Provider Demographics
NPI:1710263405
Name:GEST, VINCENT B (CP, BOCO)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:B
Last Name:GEST
Suffix:
Gender:M
Credentials:CP, BOCO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 E DAILY DR
Mailing Address - Street 2:SUITE 122
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-5806
Mailing Address - Country:US
Mailing Address - Phone:805-389-0272
Mailing Address - Fax:805-389-0259
Practice Address - Street 1:601 E DAILY DR
Practice Address - Street 2:SUITE 122
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-5806
Practice Address - Country:US
Practice Address - Phone:805-389-0272
Practice Address - Fax:805-389-0259
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist