Organization
CHILDRENS CRITICAL CARE OF VENTURA COUNTY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN W. MARCUM MD (PRESIDENT)
(805) 338-2395
Entity
Organization
Contact information
Practice address
3291 LOMA VISTA RD, VENTURA, CA 93003-3099
(805) 652-6000
Mailing address
3116 W MARCH LN, SUITE 200, STOCKTON, CA 95219-2369
(209) 473-6555
(209) 473-6544
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
Primary
A75408
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
CA
Enumeration date
07/01/2010
Last updated
07/01/2010
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