Organization Active NPI

Childrens Critical Care of Ventura County, Inc

  • Pediatric Anesthesiology Physician
  • Ventura, CA
National Provider Identifier
1285945535
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
A75408 Issued in CA
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

Updated by the provider on Jul 1, 2010

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)CodeLicenseStatePrimary
Pediatric Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
PENDINGMedicaidCA

National Provider Directory

National Provider Directory

NPI 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.

Verify at the official NPI Registry.