Organization
MED E STAFF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RONALD J BALDONADO (PRESIDENT/CEO)
(805) 644-4809
Entity
Organization
Contact information
Practice address
3418 LOMA VISTA RD, SUITE 1A, VENTURA, CA 93003-3016
(805) 644-4809
(805) 654-7090
Mailing address
3418 LOMA VISTA RD, SUITE 1A, VENTURA, CA 93003-3016
(805) 644-4809
(805) 654-7090
Taxonomy
Speciality
Code
Description
License number
State
261QC1800X
Corporate Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000600138
MEDICARE SUBMITTER ID
CA
Enumeration date
10/21/2008
Last updated
10/21/2008
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