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Organization

COM FAM PRACT URGENT

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL S DATLOW MD (MD)
(805) 648-5268
Entity
Organization

Contact information

Practice address
2715 E MAIN ST, VENTURA, CA 93003-2803
(805) 648-5268
(805) 648-5260
Mailing address
2715 E MAIN ST, VENTURA, CA 93003-2803
(805) 648-5268
(805) 648-5260

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C39479
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00C394790
CA
Enumeration date
07/12/2007
Last updated
11/07/2007
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