| Brent Street Family Practice | |
|
168 N Brent St Ste 502 Ventura CA 93003-2817 | |
| (805) 641-2000 | |
| (805) 653-1644 |
| Full Name | Brent Street Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 168 N Brent St, Ventura, California |
| Authorized Official Name and Position | Robert F Dodge (PRESIDENT) |
| Authorized Official Contact | 8056412000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brent Street Family Practice 168 N Brent St Ste 502 Ventura CA 93003-2817 Ph: (805) 641-2000 | Brent Street Family Practice 168 N Brent St Ste 502 Ventura CA 93003-2817 Ph: (805) 641-2000 |
| NPI Number | 1063565604 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063565604 | NPI | - | NPPES |
| 00G266500 | Medicaid | CA | |
| 00G405940 | Medicaid | CA | |
| 00G460520 | Medicaid | CA | |
| 00G439250 | Medicaid | CA |
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