| Oxnard Medical Group Inc | |
|
12511 Oxnard St North Hollywood CA 91606-4458 | |
| (818) 762-2084 | |
| (818) 762-2085 |
| Full Name | Oxnard Medical Group Inc |
|---|---|
| Speciality | General Practice |
| Location | 12511 Oxnard St, North Hollywood, California |
| Authorized Official Name and Position | Amable R Aguiluz (PRESIDENT) |
| Authorized Official Contact | 8187622084 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oxnard Medical Group Inc 12511 Oxnard St North Hollywood CA 91606-4458 Ph: (818) 762-2084 | Oxnard Medical Group Inc 12511 Oxnard St North Hollywood CA 91606-4458 Ph: (818) 762-2084 |
| NPI Number | 1104487776 |
|---|---|
| Provider Enumeration Date | 06/25/2019 |
| Last Update Date | 06/25/2019 |
| Medicare PECOS PAC ID | 8224461843 |
|---|---|
| Medicare Enrollment ID | O20191211002752 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104487776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Amable R Aguiluz |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1598812596 PECOS PAC ID: 9032000211 Enrollment ID: I20040324001589 |
| Provider Name | Maribeth Floresta Mckinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578878948 PECOS PAC ID: 6406154822 Enrollment ID: I20190722001323 |
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