VISTA DEL MAR MEDICAL GROUP, INC (NPI# 1942239694) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942239694 |
| Entity Type | Organization |
| Organization Name | VISTA DEL MAR MEDICAL GROUP, INC |
| Other Organization Name | N/A |
| Practice Address |
1200 W Gonzales Rd Suite 300 Oxnard CA 93036-3072 |
| Practice Telephone | 8052789094 |
| Practice Fax Number | 8052788964 |
| Mailing Telephone | 8052789094 |
| Mailing Fax Number | 8052788964 |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2010-01-14 |
| Authorized Official Name | MR. RICHARD K WESTERDOLL (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8052789094 |
| Authorized Official Credential | CAAMA, CMM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | FNP4189 | CA | Allopathic & Osteopathic Physicians |
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
FNP4189 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BLUE CROSS | ZZZ34679Z | 01 |
| CA | ZZZ75566Z | 05 | |
| CA | MEDICARE RAILROAD | 110039977 | 01 |
| Other Name | Type Code |
|---|---|
| N/A | Other Name - Individual/Organization |
| Street Address |
1200 W GONZALES RD SUITE 300 |
| City | OXNARD |
| State | CA |
| Zip Code | 93036-3072 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144610395 | Kalena Lanuza | Nurse Practitioner | 1200 W Gonzales Rd, Oxnard, CA 93036-3072 | 2015-01-27 |
| 1922201003 | Rajendra P Niraula | Internal Medicine | 1200 W Gonzales Rd, Suite 300, Oxnard, CA 93036-3072 | 2007-06-07 |
| 1588738991 | Tane Liu | Internal Medicine | 1200 W Gonzales Rd, Suite 300, Oxnard, CA 93036-3072 | 2006-11-17 |
| 1346314754 | Aron H.r. Swerdlin | Internal Medicine | 1200 W Gonzales Rd, Suite 300, Oxnard, CA 93036-3072 | 2006-11-17 |
| 1235203647 | Frank Chieu | Internal Medicine | 1200 W Gonzales Rd, Suite 300, Oxnard, CA 93036-3072 | 2006-11-17 |
| 1386718799 | Steven Glenn Ledesma | Internal Medicine | 1200 W Gonzales Rd, Suite 300, Oxnard, CA 93036-3072 | 2006-11-17 |
| 1457425860 | Nicholas Edward Bednarski | Internal Medicine | 1200 W Gonzales Rd, Suite 300, Oxnard, CA 93036-3072 | 2006-11-17 |
| 1669561536 | Ali Pardis Dana | Internal Medicine | 1200 W Gonzales Rd, Suite 300, Oxnard, CA 93036-3072 | 2006-10-11 |
| 1629080999 | Kathleen Moreau Smith | Nurse Practitioner | 1200 W Gonzales Rd, Ste 300, Oxnard, CA 93036-3072 | 2006-08-13 |
| 1376567933 | Jeima Patacsil Wachowiak | Nurse Practitioner | 1200 W Gonzales Rd, Suite 300, Oxnard, CA 93036-3072 | 2006-07-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720689508 | Cebrina Dieli | Massage Therapist | 470 Forest Park Blvd., C-212, Oxnard, CA 93036 | 2020-11-06 |
| 1760021810 | Tiffany Anne Eyestonhe | Counselor | 1911 Wiiliams Drive, Star Program, Oxnard, CA 93036 | 2020-01-06 |
| 1356903579 | Usman Khan | Student in an Organized Health Care Education/Training Program | 1911 Williams Drive Suite 200, Oxnard, CA 93036 | 2019-07-08 |
| 1689236937 | Benjamin Jonathan Ponce | Student in an Organized Health Care Education/Training Program | 1911 Williams Drive, Suite 200, Oxnard, CA 93036 | 2019-07-07 |
| 1194296806 | Ezequiel Armando Sanchez | Counselor | 1911 Williams Drive Star Program, Oxnard, CA 93036 | 2018-12-07 |
| 1710457809 | Shadi Heydari Bateni | Counselor | 2150 N. Victoria Avenue, Oxnard, CA 93036 | 2018-11-30 |
| 1023586443 | Reylene Carmen Sanchez | Counselor | 2755 Yearling Place, Oxnard, CA 93036 | 2018-11-02 |
| 1689157117 | For Eyes Optical Co. of California | Eyewear Supplier (Equipment, not the service) | 2820 Portico Way, Suite 1110, Oxnard, CA 93036 | 2018-09-11 |
| 1518445113 | Heather Christian Byhoffer | Marriage & Family Therapist | 1261 W. Gonzales Rd., Oxnard, CA 93036 | 2018-08-06 |
| 1477045110 | Dr. Jeffrey A. Saladin, Dental Corp | Dentist | 2100 Solar Drive, Suite 200, Oxnard, CA 93036 | 2018-05-30 |
| Find all providers in zip 93036 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669561536 | Ali Pardis Dana | Internal Medicine | 1200 W Gonzales Rd, Suite 300, Oxnard, CA 93036-3072 | 2006-10-11 |
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| 1326609496 | Alliance Hospitalist Medical Corporation | Internal Medicine | 3300 E South St Ste 307, Lakewood, CA 90805 | 2019-06-27 |
| 1669930723 | Adventist Health Physicians Network | Internal Medicine | 111 Raley Blvd Ste 160, Chico, CA 95928-8351 | 2019-03-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.