| Wellspring Family Medical Group Of Ventura County | |
|
5850 Thille St Suite 101 Ventura CA 93003-5413 | |
| (805) 639-9332 | |
| (805) 639-9367 |
| Full Name | Wellspring Family Medical Group Of Ventura County |
|---|---|
| Speciality | Family Medicine |
| Location | 5850 Thille St, Ventura, California |
| Authorized Official Name and Position | James Edward Hermann (PRESIDENT) |
| Authorized Official Contact | 8056399332 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wellspring Family Medical Group Of Ventura County 5850 Thille St Suite 101 Ventura CA 93003-5413 Ph: (805) 639-9332 | Wellspring Family Medical Group Of Ventura County 5850 Thille St Suite 101 Ventura CA 93003-5413 Ph: (805) 639-9332 |
| NPI Number | 1578750121 |
|---|---|
| Provider Enumeration Date | 09/27/2007 |
| Last Update Date | 09/20/2012 |
| Medicare PECOS PAC ID | 7810073178 |
|---|---|
| Medicare Enrollment ID | O20080326000818 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578750121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | James E Hermann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861442899 PECOS PAC ID: 7113936329 Enrollment ID: I20060417000773 |
| Provider Name | Eric Todd Birdwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235320722 PECOS PAC ID: 5193815702 Enrollment ID: I20071219000886 |
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