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Organization
SANTA CLARA VALLEY MEDICAL GROUP INC.
Active
Organization
SANTA CLARA VALLEY MEDICAL GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR DOMINGUEZ M.D. (PRESIDENT)
(805) 525-9595
Entity
Organization
Contact information
Practice address
147 N BRENT ST, VENTURA, CA 93003-2809
(805) 652-5011
(805) 667-2865
Mailing address
2705 LOMA VISTA RD, SUITE 205, VENTURA, CA 93003-1581
(805) 667-2801
(805) 667-2865
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A55866
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0103120
MEDI-CAL
CA
Enumeration date
02/21/2007
Last updated
08/22/2020
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