Provider Demographics
NPI:1730116930
Name:CHOCHINOV, RONALD H (MD)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:H
Last Name:CHOCHINOV
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 1:168 N BRENT ST
Mailing Address - Street 2:SUITE 405
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2817
Mailing Address - Country:US
Mailing Address - Phone:805-667-3909
Mailing Address - Fax:805-667-3915
Practice Address - Street 1:168 N BRENT ST
Practice Address - Street 2:SUITE 405
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2817
Practice Address - Country:US
Practice Address - Phone:805-667-3909
Practice Address - Fax:805-667-3915
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC37820207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C378200Medicaid
A36761Medicare UPIN
CA00C378200Medicaid