Provider Demographics
NPI:1871166496
Name:COMMUNITY PHYSICIANS OF VENTURA COUNTY
Entity type:Organization
Organization Name:COMMUNITY PHYSICIANS OF VENTURA COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:REISMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-647-5174
Mailing Address - Street 1:5855 OLIVAS PARK DR
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-7672
Mailing Address - Country:US
Mailing Address - Phone:805-667-2801
Mailing Address - Fax:805-667-2865
Practice Address - Street 1:1280 S VICTORIA AVE STE 201
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-6551
Practice Address - Country:US
Practice Address - Phone:805-642-1699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY PHYSICIANS OF VENTURA COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-07-21
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty