Moustapha Abou-Samra, MD
Individual provider Active NPI Neurological Surgery Physician · Ventura, CA
NPI 1194719807 · NPPES record last updated May 19, 2015
Key facts
- NPI
- 1194719807
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurological Surgery Physician 207T00000X
- License
- A36688 (CA)
- Practice address
- 168 N Brent St
Ste 408
Ventura, CA 93003-2824 - Phone
- (805) 643-2179
- Fax
- (805) 643-0672
- NPI assigned
- Sep 8, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36688 | CA | MD | Dentist |
| A36688 | CA | MD | Neurological Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ventura County Neurosurgery Associates Medical Group | Neurological Surgery | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | A36688 | CA | Yes |
Addresses
Primary practice location
168 N Brent St
Ste 408
Ventura, CA 93003-2824
Mailing address
168 N Brent St
Ste 408
Ventura, CA 93003-2824
Phone (805) 643-2179
Other providers in Ventura, CA
- Itamara Abedi
- Nicole Lynn Abell
- Jenna Abeloe
- Anna Marie Aberion
- Eleanor Abiva
- Academic Family Medicine Clinic-MH
- Accent Home Health Inc
- Samantha Accornero
- Ace General Construction Inc
- Ace Home Care
All providers in Ventura, CA · Neurological Surgery Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.