| Com Fam Pract Urgent | |
|
2715 E Main St Ventura CA 93003-2803 | |
| (805) 648-5268 | |
| (805) 648-5260 |
| Full Name | Com Fam Pract Urgent |
|---|---|
| Speciality | Family Medicine |
| Location | 2715 E Main St, Ventura, California |
| Authorized Official Name and Position | Michael S Datlow (MD) |
| Authorized Official Contact | 8056485268 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Com Fam Pract Urgent 2715 E Main St Ventura CA 93003-2803 Ph: (805) 648-5268 | Com Fam Pract Urgent 2715 E Main St Ventura CA 93003-2803 Ph: (805) 648-5268 |
| NPI Number | 1972702702 |
|---|---|
| Provider Enumeration Date | 07/12/2007 |
| Last Update Date | 11/07/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972702702 | NPI | - | NPPES |
| 00C394790 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C39479 (California) | Primary |
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