| Kids And Parents Medical Center | |
|
2772 Johnson Dr Suite 114 Ventura CA 93003 | |
| (805) 644-3311 | |
| (805) 644-2161 |
| Full Name | Kids And Parents Medical Center |
|---|---|
| Speciality | Family Medicine |
| Location | 2772 Johnson Dr, Ventura, California |
| Authorized Official Name and Position | Barry Matthew Cogen (DIRECTOR) |
| Authorized Official Contact | 8056443311 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kids And Parents Medical Center 2772 Johnson Dr Suite 114 Ventura CA 93003 Ph: (805) 644-3311 | Kids And Parents Medical Center 2772 Johnson Dr Suite 114 Ventura CA 93003 Ph: (805) 644-3311 |
| NPI Number | 1427237650 |
|---|---|
| Provider Enumeration Date | 10/24/2007 |
| Last Update Date | 10/24/2007 |
| Medicare PECOS PAC ID | 9032145875 |
|---|---|
| Medicare Enrollment ID | O20050712001321 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427237650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 20A5574 (California) | Primary |
| 2081S0010X | Physical Medicine & Rehabilitation - Sports Medicine | 20A5574 (California) | Secondary |
| Provider Name | Barry M Cogen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134285570 PECOS PAC ID: 1052349081 Enrollment ID: I20050801000800 |
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