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Organization

GENERAL SURGERY MEDICAL GROUP OF VENTURA COUNTY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TIMOTHY GORDON BRYANT M.D. (MANAGING PARTNER)
(805) 485-8722
Entity
Organization

Contact information

Practice address
1700 N ROSE AVE, SUITE 430, OXNARD, CA 93030-3790
(805) 485-8722
(805) 485-9311
Mailing address
1700 N ROSE AVE, SUITE 430, OXNARD, CA 93030-3790
(805) 485-8722
(805) 485-9311

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0027300
CA
01
YYY49967Y
BLUE SHIELD
CA
Enumeration date
01/05/2006
Last updated
11/13/2008
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