NPIMap

Organization Active NPI

Ci Marina Medical Inc

  • Family Medicine Physician
  • Oxnard, CA
National Provider Identifier
1609106467
Registry record updated Sep 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A4379 Issued in CA
Legal business name
CI MARINA MEDICAL INC
Practice address
4310 Tradewinds Dr
Ste 300
Oxnard, CA 93035-1407
Phone
(805) 985-5880
Fax
(805) 984-9839
NPI assigned
Dec 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2010

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

Authorized official

Name
Dr. Gary Robert Mitnick, D.O.NPI 1568499838
Title
President
Phone
(805) 985-5880

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 20A4379 CA Primary

Addresses

Primary practice location

4310 Tradewinds Dr
Ste 300
Oxnard, CA 93035-1407

Mailing address

4310 Tradewinds Dr
Ste 300
Oxnard, CA 93035-1407
Phone (805) 985-5880

Other identifiers 1

IdentifierTypeStateIssuer
20A4379OtherCAMEDICAL LICENSE NUMBER

Other names 1

  • Gary R Mitnick DO Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284940800000",
    "number": "1609106467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 TRADEWINDS DR",
            "address_2": "STE 300",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930351407",
            "telephone_number": "805-985-5880",
            "fax_number": "805-984-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 TRADEWINDS DR",
            "address_2": "STE 300",
            "city": "OXNARD",
            "state": "CA",
            "postal_code": "930351407",
            "telephone_number": "805-985-5880",
            "fax_number": "805-984-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CI MARINA MEDICAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-29",
        "last_updated": "2010-09-20",
        "status": "A",
        "authorized_official_last_name": "MITNICK",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-985-5880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A4379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE NUMBER",
            "identifier": "20A4379",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gary R Mitnick DO",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Oxnard, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.