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Individual

JILL E. FURGURSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
147 N BRENT ST, VENTURA, CA 93003-2809
(805) 652-5051
(805) 585-3007
Mailing address
23941 DE VILLE WAY, MALIBU, CA 90265-4894
(310) 456-3036
(310) 456-2451

Taxonomy

Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
G36815
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
050394
BLUE CROSS
CA
01
95-1683892
OTHER INSURANCE
CA
05
HSC30394F
CA
05
ZZT40394F
CA
01
ZZZ53994Z
BLUE SHIELD
CA
01
ZZZA56032
BLUE SHIELD
CA
Enumeration date
11/22/2006
Last updated
07/11/2012
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