Organization
ISLAND VIEW GASTROENTEROLOGY ASSOC.
Active
Organization
ISLAND VIEW GASTROENTEROLOGY ASSOC.
Active
Other names
COVINGTON MENZ LYCHE & LIN MEDICAL GP, ISLAND VIEW GASTROENTEROLOGY ASSOCIATES
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN M IZQUIERDO (MANAGER)
(805) 641-6525
Entity
Organization
Contact information
Practice address
168 N BRENT ST STE 404, VENTURA, CA 93003
(805) 641-6525
(805) 641-6530
Mailing address
168 N BRENT ST STE 404, VENTURA, CA 93003-2824
(805) 641-6525
(805) 641-6530
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386701787
MANAGER
CA
05
—
1386701787
—
CA
05
—
WA78582A
—
CA
05
—
WG232764B
—
CA
05
—
WG25356B
—
CA
05
—
WG62357C
—
CA
05
—
WG83685A
—
CA
05
—
WPA18127A
—
CA
Enumeration date
01/03/2007
Last updated
08/20/2021
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