NPIMap

Organization Active NPI

Harbor Family and Pediatric Medical

Doing business as Channel Islands Medical Group

  • Specialist
  • Ventura, CA
National Provider Identifier
1679759286
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
A71919 Issued in CA
Legal business name
HARBOR FAMILY AND PEDIATRIC MEDICAL
Doing business as
Channel Islands Medical Group
Practice address
2755 Loma Vista Rd
Ventura, CA 93003-1544
Phone
(805) 477-9922
Fax
(805) 477-9937
NPI assigned
Jan 14, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Authorized official

Name
Dr. Dean Walter Smith, M.D.
Title
Medical Director
Phone
(805) 477-9922

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X A71919 CA Primary

Addresses

Primary practice location

2755 Loma Vista Rd
Ventura, CA 93003-1544

Mailing address

2755 Loma Vista Rd
Ventura, CA 93003-1544
Phone (805) 477-9922

Other names 1

  • Channel Islands Medical Group Doing business as

National Provider Directory

National Provider Directory

Locations

3639 Harbor Blvd
Ste 106
Ventura, CA 93001
Phone (805) 477-9922

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611792000000",
    "number": "1679759286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2755 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031544",
            "telephone_number": "805-477-9922",
            "fax_number": "805-477-9937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 LOMA VISTA RD",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930031544",
            "telephone_number": "805-477-9922",
            "fax_number": "805-477-9937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARBOR FAMILY AND PEDIATRIC MEDICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-14",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "WALTER",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "805-477-9922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "A71919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Channel Islands Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Channel Islands Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 28, 2021; 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.