| Clinicas Del Camino Real, Inc. Simi Valley Madera | |
|
1424 Madera Rd Simi Valley CA 93065-3000 | |
| (805) 522-5722 | |
| (805) 672-0107 |
| Full Name | Clinicas Del Camino Real, Inc. Simi Valley Madera |
|---|---|
| Speciality | Clinic/Center |
| Location | 1424 Madera Rd, Simi Valley, California |
| Authorized Official Name and Position | Farhad Benharash (CHIEF FINANCIAL OFFCIER) |
| 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. Simi Valley Madera 200 S Wells Rd Suite 200 Ventura CA 93004-1377 Ph: (805) 659-1740 | Clinicas Del Camino Real, Inc. Simi Valley Madera 1424 Madera Rd Simi Valley CA 93065-3000 Ph: (805) 522-5722 |
| NPI Number | 1720362056 |
|---|---|
| Provider Enumeration Date | 10/05/2011 |
| Last Update Date | 06/07/2022 |
| Medicare PECOS PAC ID | 3173434396 |
|---|---|
| Medicare Enrollment ID | O20120705000528 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720362056 | NPI | - | NPPES |
| 1720362056 | Medicaid | CA |
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