Provider Demographics
NPI:1134527740
Name:STANLEY FROCHTZWAJG, M.D.
Entity type:Organization
Organization Name:STANLEY FROCHTZWAJG, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:FROCHTZWAJG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-641-1780
Mailing Address - Street 1:2629 LOMA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1548
Mailing Address - Country:US
Mailing Address - Phone:805-641-1780
Mailing Address - Fax:
Practice Address - Street 1:3020 PENINSULA RD
Practice Address - Street 2:#641
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93035-4059
Practice Address - Country:US
Practice Address - Phone:901-605-1758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-12
Last Update Date:2014-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23021363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty