| St Nazarene Medical Clinic Inc | |
|
1100 N Ventura Rd Suite 109 Oxnard CA 93030-3841 | |
| (805) 983-0547 | |
| (805) 983-0423 |
| Full Name | St Nazarene Medical Clinic Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1100 N Ventura Rd, Oxnard, California |
| Authorized Official Name and Position | Suzanne L Fussell (PRESIDENT) |
| Authorized Official Contact | 8059830547 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Nazarene Medical Clinic Inc 1100 North Ventura Rd Suite 109 Oxnard CA 93030-3814 Ph: (805) 983-0547 | St Nazarene Medical Clinic Inc 1100 N Ventura Rd Suite 109 Oxnard CA 93030-3841 Ph: (805) 983-0547 |
| NPI Number | 1275714917 |
|---|---|
| Provider Enumeration Date | 11/23/2007 |
| Last Update Date | 01/14/2011 |
| Medicare PECOS PAC ID | 4082875547 |
|---|---|
| Medicare Enrollment ID | O20120411000254 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275714917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A055383 (California) | Primary |
| Provider Name | Suzanne L Fussell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942394457 PECOS PAC ID: 6800706201 Enrollment ID: I20120328000817 |
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