Provider Demographics
NPI:1912306317
Name:COUNTY OF VENTURA
Entity Type:Organization
Organization Name:COUNTY OF VENTURA
Other - Org Name:MOORPARK FAMILY MEDICAL GROUP / MOORPARK COLLEGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:NARCISA
Authorized Official - Middle Name:
Authorized Official - Last Name:EGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-677-5140
Mailing Address - Street 1:2323 KNOLL DR STE 219
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7307
Mailing Address - Country:US
Mailing Address - Phone:805-677-5312
Mailing Address - Fax:805-677-5304
Practice Address - Street 1:7075 CAMPUS RD
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-1605
Practice Address - Country:US
Practice Address - Phone:805-378-1413
Practice Address - Fax:805-378-1570
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VENTURA COUNTY MEDICAL VENTURA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-08-21
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health