Active NPI
Ken Calvin Hidaka, M.D.
- Anesthesiology Physician
- Ventura, CA
National Provider Identifier
1811067085
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- G69422
- Practice address
- 3525 Loma Vista Rd
Ventura, CA 93003-3101 - Phone
- (805) 641-6434
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G69422 | CA | Primary |
Addresses
Primary practice location
3525 Loma Vista Rd
Ventura, CA 93003-3101
Mailing address
3418 Loma Vista Road
Suite a
Ventura, CA 93033-3015
Phone (805) 642-8565
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050215001153 | CA | Practitioner - Anesthesiology | 0547212706 | Practice locations: Ventura, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 69422 | CA | MD | Pharmacist |
| G69422 | CA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225152000000",
"number": "1811067085",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3418 LOMA VISTA ROAD",
"address_2": "SUITE A",
"city": "VENTURA",
"state": "CA",
"postal_code": "930333015",
"telephone_number": "805-642-8565",
"fax_number": "805-642-8564"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3525 LOMA VISTA RD",
"city": "VENTURA",
"state": "CA",
"postal_code": "930033101",
"telephone_number": "805-641-6434"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HIDAKA",
"first_name": "KEN",
"middle_name": "CALVIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2008-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "G69422",
"primary": true
}
],
"identifiers": [],
"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 Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.