Provider Demographics
NPI:1912135179
Name:CLINICAS DEL CAMINO REAL, INCORPORATED
Entity Type:Organization
Organization Name:CLINICAS DEL CAMINO REAL, INCORPORATED
Other - Org Name:CLINICAS DEL CAMINO REAL, INC., VENTURA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:FARHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:BENHARASH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-659-1740
Mailing Address - Street 1:200 S WELLS RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93004-1377
Mailing Address - Country:US
Mailing Address - Phone:805-659-1740
Mailing Address - Fax:805-659-9959
Practice Address - Street 1:200 S WELLS RD
Practice Address - Street 2:ROOM 1
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93004-1377
Practice Address - Country:US
Practice Address - Phone:805-647-6322
Practice Address - Fax:805-647-7164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-26
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy