Organization
CLINICAS DEL CAMINO REAL INC
Active
Other names
Clinicas del Camino Real Inc Newbury Park
Organization subpart
No
Provider details
NPI number
Authorized official
FARHAD BENHARASH (CHIEF FINANCIAL OFICER)
(805) 659-1740
Entity
Organization
Contact information
Practice address
1000 NEWBURY RD, SUITE 150, NEWBURY PARK, CA 91320-6435
(805) 498-3640
(805) 498-3641
Mailing address
200 S WELLS RD STE 150, VENTURA, CA 93004-1380
(805) 659-2752
(805) 659-9959
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
550000384
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCP71164F
EDS CANCER DETECTION PROG
CA
05
—
CMM71164F
—
CA
05
—
FHC71164F
—
CA
01
—
HAP71164F
HEALTH ACCESS PROGRAM
CA
01
—
ZZZ62823Z
BLUE SHIELD
CA
Enumeration date
04/17/2007
Last updated
06/07/2022
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