Organization
CLINICAS DEL CAMINO REAL INC
Active
Other names
Clinicas del Camino Real Inc Maravilla
Organization subpart
No
Provider details
NPI number
Authorized official
FARHAD BENHARASH (CHIEF FINANCIAL OFFICER)
(805) 659-1740
Entity
Organization
Contact information
Practice address
450 W CLARA ST, OXNARD, CA 93033-8363
(805) 488-0210
Mailing address
200 S WELLS RD, SUITE 200, VENTURA, CA 93004-1302
(805) 659-1740
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
050000461
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCP70666F
EDS CDP EVERY WOMAN COUNT
CA
05
—
FHC70666F
—
CA
01
—
HAP70666F
HEALTH ACCESS PROGRAM FAM
CA
01
—
ZZZ06123Z
BLUE SHIELD
CA
Enumeration date
04/17/2007
Last updated
06/07/2022
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