Organization
THERESA ENRIQUEZ, MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA ENRIQUEZ M.D. (PRESIDENT)
(805) 394-0898
Entity
Organization
Contact information
Practice address
210 W 7TH ST, OXNARD, CA 93030-7173
(805) 394-0898
(805) 394-0897
Mailing address
210 W 7TH ST, OXNARD, CA 93030-7173
(805) 394-0898
(805) 394-0897
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
G49327
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G4932700
—
CA
Enumeration date
09/04/2014
Last updated
09/04/2014
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