| Clinicas Del Camino Real Inc Maravilla | |
|
450 W Clara St Oxnard CA 93033-8363 | |
| (805) 488-0210 | |
| Not Available |
| Full Name | Clinicas Del Camino Real Inc Maravilla |
|---|---|
| Speciality | Clinic/Center |
| Location | 450 W Clara St, Oxnard, California |
| Authorized Official Name and Position | Farhad Benharash (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 8056591740 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinicas Del Camino Real Inc Maravilla 200 S Wells Rd Suite 200 Ventura CA 93004-1302 Ph: (805) 659-1740 | Clinicas Del Camino Real Inc Maravilla 450 W Clara St Oxnard CA 93033-8363 Ph: (805) 488-0210 |
| NPI Number | 1518183904 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 06/07/2022 |
| Medicare PECOS PAC ID | 3173434396 |
|---|---|
| Medicare Enrollment ID | O20030909000039 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518183904 | NPI | - | NPPES |
| ZZZ06123Z | Other | CA | BLUE SHIELD |
| HAP70666F | Other | CA | HEALTH ACCESS PROGRAM FAM |
| FHC70666F | Medicaid | CA | |
| BCP70666F | Other | CA | EDS CDP EVERY WOMAN COUNT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 050000461 (California) | Primary |
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