Organization
CLINICAS DEL CAMINO REAL INC
Active
Other names
Clinicas del Camino Real Inc Santa Paula
Organization subpart
No
Provider details
NPI number
Authorized official
FARHAD BENHARASH (CHIEF FINANCIAL OFFICER)
(805) 659-1740
Entity
Organization
Contact information
Practice address
500 E MAIN ST, SANTA PAULA, CA 93060-2607
(805) 933-0895
Mailing address
200 S WELLS RD, SUITE 200, VENTURA, CA 93004-1302
(805) 659-1740
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
050000511
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCP70777F
EDS CDP EVERY WOMAN COUNT
CA
05
—
FHC70777F
—
CA
01
—
HAP70777F
HEALTH ACCESS PROGRAM FAM
CA
01
—
ZZZ79971Z
BLUE SHIELD
CA
Enumeration date
04/17/2007
Last updated
06/07/2022
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