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Individual

IVAN L VENTURA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
301 E 13TH ST, MERCED, CA 95340-6211
(209) 385-7201
(209) 385-7066
Mailing address
2838 MARIE LN, MERCED, CA 95340-2611
(209) 725-1229
(209) 725-1229

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA17129
CA
364SE0003X
Emergency Clinical Nurse Specialist
Primary
PA17129
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0PA171290
CA
05
1295706661
CA
05
PA17129
CA
Enumeration date
02/01/2006
Last updated
04/28/2009
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