| Niruyispc | |
|
3037 Martha Dr Ventura CA 93003-2934 | |
| (805) 656-6911 | |
| (805) 643-2671 |
| Full Name | Niruyispc |
|---|---|
| Speciality | Exclusive Provider Organization |
| Location | 3037 Martha Dr, Ventura, California |
| Authorized Official Name and Position | Sam Niruyi (PRESIDENT) |
| Authorized Official Contact | 6023200246 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Niruyispc 3037 Martha Dr Ventura CA 93003-2934 Ph: (805) 656-6911 | Niruyispc 3037 Martha Dr Ventura CA 93003-2934 Ph: (805) 656-6911 |
| NPI Number | 1831273002 |
|---|---|
| Provider Enumeration Date | 10/25/2006 |
| Last Update Date | 05/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831273002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D5292 (Arizona) | Secondary |
| 302F00000X | Exclusive Provider Organization | 56796 (California) | Primary |
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