Individual
DR. IMELDA DE FOREST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1700 N ROSE AVE STE 280, OXNARD, CA 93030-7645
(805) 384-8071
(805) 981-6201
Mailing address
3400 DATA DR, ATTN: CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A51405
CA
Other
Enumeration date
11/02/2006
Last updated
10/03/2025
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