Community Memorial Health System
Organization Active NPI Multi-Specialty Clinic/Center · Oxnard, CA
NPI 1124067574 · NPPES record last updated Jun 21, 2018
Key facts
- NPI
- 1124067574
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- Legal business name
- COMMUNITY MEMORIAL HEALTH SYSTEM
- Practice address
- 250 Citrus Grove LN
#150
Oxnard, CA 93036-9030 - Phone
- (805) 981-3770
- Fax
- (805) 981-3767
- NPI assigned
- Jun 4, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- COMMUNITY MEMORIAL HEALTH SYSTEM
Authorized official
- Name
- Mr. Gary Wilde
- Title
- Ceo
- Phone
- (805) 652-5011
Other NPIs on the same Medicare enrollment 21
Practitioners 75
-
Mark F Barrett, M.D.
-
Marc A Beaghler, M.D.
-
Erin Frances Bergeron, M.D.
-
Erik Bezema, MD
-
Vicky Bobadilla, PA-C
-
Ronald Dan Bogoian, DPM
-
Gabriela Broughal, PA-C
-
Logan K. Bundy, M.D.
-
Kelly L Calkins, PA
-
Christine Camara, P.A.
-
Khozema Hatim Campwala, MD., MPH
-
Suseela Dasari, M.D.
-
Michelle L Daucett, D.O.
-
Heidi Liliana Escurra, M.D.
-
Shahram Fatemi, M.D.
-
Hany C Fouad, M.D.
-
James Paul Gay, M.D.
-
Jeanne Gilbert, P.A.
-
Michael Stephen Green, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040422001668 | CA | Part B Supplier - Clinic/Group Practice | 9537155676 |
Receives reassigned benefits from 274 practitioners 21 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Ventura, CA; Port Hueneme, CA; Oxnard, CA; Camarillo, CA; Fillmore, CA; Ojai, CA |
National Provider Directory
- Part of
- Community Pharmacy
Locations
250 Citrus Grove Ln
Ste 150
Oxnard, CA 93036
Phone (805) 981-3770
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | Yes | ||
| VA Clinic/Center | 261QV0200X |
Addresses
Primary practice location
250 Citrus Grove LN
#150
Oxnard, CA 93036-9030
Mailing address
5855 Olivas Park Dr
Ventura, CA 93003-7672
Phone (805) 667-2801
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZT40394F | Medicaid | CA |
Other names
- CMH Centers for Family Health
Other providers in Oxnard, CA
- Symone Collins
- Gil Ilano Colmenar
- Joseph Andrew Combs
- Comfort Care Enterprises
- Community Medical Specialists Inc
- Community Memorial Health System
- Community Memorial Health System
- Community Memorial Health System
- Community Memorial Health System
- Community Memorial Hospita
All providers in Oxnard, CA · Multi-Specialty Clinic/Center in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.