Provider Demographics
NPI:1376959957
Name:OXNARD INSTITUTE
Entity type:Organization
Organization Name:OXNARD INSTITUTE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:MYLES
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:559-274-7174
Mailing Address - Street 1:6338 N MAROA AVE
Mailing Address - Street 2:113
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-1554
Mailing Address - Country:US
Mailing Address - Phone:559-274-7174
Mailing Address - Fax:
Practice Address - Street 1:6338 N MAROA AVE
Practice Address - Street 2:113
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93704-1554
Practice Address - Country:US
Practice Address - Phone:559-274-7174
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
347C00000X
CACPT00003318291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
No347C00000XTransportation ServicesPrivate Vehicle