Provider Demographics
NPI:1952363376
Name:VENTAYEN, ROWENA VELASQUEZ (MD)
Entity Type:Individual
Prefix:
First Name:ROWENA
Middle Name:VELASQUEZ
Last Name:VENTAYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROWENA
Other - Middle Name:G
Other - Last Name:VELASQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3008 SILLECT AVE
Mailing Address - Street 2:SUITE 240
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93308-6340
Mailing Address - Country:US
Mailing Address - Phone:661-616-9300
Mailing Address - Fax:661-616-9301
Practice Address - Street 1:3008 SILLECT AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93308-6340
Practice Address - Country:US
Practice Address - Phone:661-616-9300
Practice Address - Fax:661-616-9301
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66323207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH08414Medicare UPIN
CA00A66323Medicare ID - Type UnspecifiedACTIVE