Active NPI
Childrens Critical Care of Ventura County, Inc
- Pediatric Anesthesiology Physician
- Ventura, CA
National Provider Identifier
1285945535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Anesthesiology Physician
- License
- A75408
- Legal business name
- CHILDRENS CRITICAL CARE OF VENTURA COUNTY, INC
- Practice address
- 3291 Loma Vista Rd
Ventura, CA 93003-3099 - Phone
- (805) 652-6000
- NPI assigned
- Jul 1, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- John W. Marcum, MD
- Title
- President
- Phone
- (805) 338-2395
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Anesthesiology Physician | 207LP3000X | A75408 | CA | Primary |
Addresses
Primary practice location
3291 Loma Vista Rd
Ventura, CA 93003-3099
Mailing address
3116 W March LN
Suite 200
Stockton, CA 95219-2369
Phone (209) 473-6555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PENDING | Medicaid | CA |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277942400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1277942400000",
"number": "1285945535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3116 W MARCH LN",
"address_2": "SUITE 200",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952192369",
"telephone_number": "209-473-6555",
"fax_number": "209-473-6544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3291 LOMA VISTA RD",
"city": "VENTURA",
"state": "CA",
"postal_code": "930033099",
"telephone_number": "805-652-6000"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHILDRENS CRITICAL CARE OF VENTURA COUNTY, INC",
"organizational_subpart": "NO",
"enumeration_date": "2010-07-01",
"last_updated": "2010-07-01",
"status": "A",
"authorized_official_last_name": "MARCUM",
"authorized_official_first_name": "JOHN",
"authorized_official_middle_name": "W.",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "805-338-2395",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207LP3000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology, Pediatric Anesthesiology",
"state": "CA",
"license": "A75408",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PENDING",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ventura, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.