Provider Demographics
NPI:1750338042
Name:GAY, JAMES PAUL (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:PAUL
Last Name:GAY
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 1:2705 LOMA VISTA RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1581
Mailing Address - Country:US
Mailing Address - Phone:805-667-2801
Mailing Address - Fax:805-667-2865
Practice Address - Street 1:655 VENTURA AVE
Practice Address - Street 2:
Practice Address - City:OAK VIEW
Practice Address - State:CA
Practice Address - Zip Code:93022-9655
Practice Address - Country:US
Practice Address - Phone:805-649-3750
Practice Address - Fax:805-649-3780
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG51718207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARHM08608FMedicaid
CARHM18553HMedicaid
CA050394OtherBLUE CROSS
CARHM08609FMedicaid
CAZZT40394FMedicaid
CA951683892OtherOTHER INSURANCE
CA951683892OtherOTHER INSURANCE
CAWG51718KMedicare ID - Type UnspecifiedPPIN
CARHM08608FMedicaid
A52062Medicare UPIN
CAWG51718FMedicare ID - Type UnspecifiedPPIN
CAWG51718IMedicare ID - Type UnspecifiedPPIN
CA050394OtherBLUE CROSS
CA058553Medicare ID - Type UnspecifiedRH MEDICARE
CARHM18553HMedicaid
CAZZT40394FMedicaid
CAWG51718JMedicare ID - Type UnspecifiedPPIN
CAWG51718HMedicare ID - Type UnspecifiedPPIN