Organization
OBV AT FILLMORE, INC
Active
Other names
Priority Healthcare Management
Organization subpart
No
Provider details
NPI number
Authorized official
ANANIAS EDUARDO GONZALEZ (PRESIDENT/CEO)
(805) 525-8900
Entity
Organization
Contact information
Practice address
1371 BLUEJAY ST, FILLMORE, CA 93015-1666
(805) 525-8900
(805) 524-1321
Mailing address
PO BOX 389, FILLMORE, CA 93016-0389
(805) 525-8900
(805) 524-1321
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
—
Other
Enumeration date
10/28/2005
Last updated
08/22/2020
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