Ventura Dermatology Medical Clinic, Inc

Primary specialty

Dermatopathology PhysicianTaxonomy code 207ND0900X

License

G18881 Issued in CA

Legal business name

VENTURA DERMATOLOGY MEDICAL CLINIC, INC

Practice address

227 N Dos Caminos Ave
Ventura, CA 93003-1660

Phone

(805) 648-6969

Fax

(805) 648-3762

NPI assigned

Jul 14, 2006

Last updated

Mar 6, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John Hollister Thacher, M.D.NPI 1205962032

Title

President/Physician

Phone

(805) 648-6969

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John Hollister Thacher, M.D.

  • Dermatopathology Physician
  • Ojai, CA
  • NPI 1205962032
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741219200000",
    "number": "1548286701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 PIRIE RD STE F",
            "city": "OJAI",
            "state": "CA",
            "postal_code": "930233100",
            "telephone_number": "805-648-6969",
            "fax_number": "805-648-3762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 N DOS CAMINOS AVE",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031660",
            "telephone_number": "805-648-6969",
            "fax_number": "805-648-3762"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VENTURA DERMATOLOGY MEDICAL CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-14",
        "last_updated": "2025-03-06",
        "certification_date": "2025-03-06",
        "status": "A",
        "authorized_official_last_name": "THACHER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "HOLLISTER",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "805-648-6969",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": "CA",
            "license": "G18881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "ZZZ71761Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ventura County Obstetric and Gynecologic Medical Group, Inc
• Ventura County Surgical Associates
• Ventura County Urology Medical Group, Inc
• Ventura Dental Care
• Ventura Dental Specialty Group
• Ventura Diagnostic Laboratory
• Ventura Ear Nose & Throat Med Group Inc
• Ventura Emergency Physicians
• Ventura Endoscopy Center LLC
• Ventura Endoscopy Center Partners LLC

• Dermatopathology Physician in Ventura, CA
• Providers in Ventura, CA by specialty
• Dermatopathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2025; 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.