Provider Demographics
NPI:1295170090
Name:VENTURA PAIN AND SPINE PHYSICIANS
Entity type:Organization
Organization Name:VENTURA PAIN AND SPINE PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:LOMBARDO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-933-5775
Mailing Address - Street 1:1730 S VICTORIA AVE STE 220
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-6179
Mailing Address - Country:US
Mailing Address - Phone:805-650-5650
Mailing Address - Fax:805-650-5656
Practice Address - Street 1:1730 S VICTORIA AVE STE 220
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-6179
Practice Address - Country:US
Practice Address - Phone:619-933-5775
Practice Address - Fax:805-650-5656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-07
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA110907207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty