Individual
DR. GOSTA W. IWASIUK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5855 OLIVAS PARK DR, VENTURA, CA 93003-7672
(805) 667-2801
(805) 667-2865
Mailing address
120 N ASHWOOD AVE, VENTURA, CA 93003-1810
(805) 658-5800
(805) 642-1928
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A22839
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A228391
—
CA
01
—
A22839
STATE LICENSE
CA
Enumeration date
09/16/2006
Last updated
01/31/2014
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