Provider Demographics
NPI:1891947982
Name:MED E STAFF
Entity Type:Organization
Organization Name:MED E STAFF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:J
Authorized Official - Last Name:BALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-644-4809
Mailing Address - Street 1:3418 LOMA VISTA RD
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-3016
Mailing Address - Country:US
Mailing Address - Phone:805-644-4809
Mailing Address - Fax:805-654-7090
Practice Address - Street 1:3418 LOMA VISTA RD
Practice Address - Street 2:SUITE 1A
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-3016
Practice Address - Country:US
Practice Address - Phone:805-644-4809
Practice Address - Fax:805-654-7090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000600138OtherMEDICARE SUBMITTER ID