Individual
JOHN P FANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3085 LOMA VISTA RD, VENTURA, CA 93003-2916
(805) 648-3085
(805) 648-7027
Mailing address
3085 LOMA VISTA RD, VENTURA, CA 93003-2916
(805) 648-3085
(805) 648-7027
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C54802
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200090320A
—
OK
01
—
C54802
CA MEDICAL LICENSE
CA
Enumeration date
08/07/2006
Last updated
12/16/2020
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