Organization
JON BELLEVILLE M D A MEDICAL CORPORATION
Active
Organization
JON BELLEVILLE M D A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON P. BELLEVILLE M.D. (PRESIDENT)
(310) 440-3131
Entity
Organization
Contact information
Practice address
1600 N ROSE AVE, OXNARD, CA 93030-3722
(805) 988-2818
Mailing address
11999 SAN VICENTE BLVD, STE. 440, LOS ANGELES, CA 90049-5131
(310) 440-3131
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G57679
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G576790
—
CA
01
—
050083025
RAILROAD MEDICARE
CA
Enumeration date
10/19/2006
Last updated
02/03/2009
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