| Clinicas Del Camino Real Inc Newbury Park | |
|
1000 Newbury Rd Suite 150 Newbury Park CA 91320-6435 | |
| (805) 498-3640 | |
| (805) 498-3641 |
| Full Name | Clinicas Del Camino Real Inc Newbury Park |
|---|---|
| Speciality | Clinic/Center |
| Location | 1000 Newbury Rd, Newbury Park, California |
| Authorized Official Name and Position | Farhad Benharash (CHIEF FINANCIAL OFICER) |
| 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 Newbury Park 200 S Wells Rd Ste 150 Ventura CA 93004-1380 Ph: (805) 659-2752 | Clinicas Del Camino Real Inc Newbury Park 1000 Newbury Rd Suite 150 Newbury Park CA 91320-6435 Ph: (805) 498-3640 |
| NPI Number | 1982820221 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 06/07/2022 |
| Medicare PECOS PAC ID | 3173434396 |
|---|---|
| Medicare Enrollment ID | O20070918000502 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982820221 | NPI | - | NPPES |
| CMM71164F | Medicaid | CA | |
| FHC71164F | Medicaid | CA | |
| HAP71164F | Other | CA | HEALTH ACCESS PROGRAM |
| ZZZ62823Z | Other | CA | BLUE SHIELD |
| BCP71164F | Other | CA | EDS CANCER DETECTION PROG |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 550000384 (California) | Primary |
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