1326384512

Everything you always wanted to know about IDENTITY MEDICAL GROUP, INC. DEUTSCH, M. GARY but were afraid to ask.

IDENTITY MEDICAL GROUP, INC. DEUTSCH, M. GARY

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Organization Name Authorized Official Last Name Authorized Official Middle Name Authorized Official First Name
IDENTITY MEDICAL GROUP, INC. DEUTSCH, M. GARY
Gender:
none
Enumeration date:
2012-12-17
Last update date:
2016-03-04
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
No

Identifiers

identifier description issuer state
HD754Z Medicare PIN none CA
HD743A Medicare PIN none CA

Taxonomies

Taxonomy State License Number Primary?
207R00000X Internal Medicine CA none

Phone Numbers

Type Number
Mailing Address Telephone Number 8052567810
Practice Location Address Telephone Number 8052567810
Authorized Official Telephone Number 8052567810
Mailing Address Fax Number 8052567840
Practice Location Address Fax Number 8052567840

Addresses

Type Address City State Postal Country
Mailing Address 2125 KNOLL DR STE 104 VENTURA CA 93003 CA
Practice Location Address 2125 KNOLL DR STE 104 VENTURA CA 93003 CA

Other NPI Records that share a phone number

NPI Name Address State City
1013164136 DICKEY, MARIA
Individual
2125 KNOLL DR CA VENTURA
1225290554 DICKEY, MICAH
Individual
247 MARCH ST CA SANTA PAULA
1245231968 YU, GEORGE
Individual
1700 N ROSE AVE CA OXNARD
1255714671 OB 24 MEDICAL GROUP, INC.
Organization
1600 N ROSE AVE CA OXNARD
1326256546 STEEN, JENNIFER
Individual
2125 KNOLL DR CA VENTURA
1366413718 NARHI, DIANE
Individual
3901 LAS POSAS RD CA CAMARILLO
1528027497 JONOKUCHI, CARL
Individual
3311 OLD CONEJO ROAD CA NEWBURY PARK
1548490964 DELOA, ANGELIKA
Individual
2125 KNOLL DR CA VENTURA
1598714107 VALIVETI, VINOD
Individual
751 E DAILY DR CA CAMARILLO
1699086769 SCHNEIDER, TERRY
Individual
751 E DAILY DR CA CAMARILLO
1780085779 BERENSHTEYN, ANYA
Individual
751 E DAILY DR CA CAMARILLO
1881895431 HOFER, CHRISTINA
Individual
2125 KNOLL DR CA VENTURA
1902805294 WONG, CALBERT
Individual
2438 N PONDEROSA DR CA CAMARILLO

Other NPI Records that share an address

NPI Name Address State City
1255714671 OB 24 MEDICAL GROUP, INC.
Organization
1600 N ROSE AVE CA OXNARD

Other NPI Records that share an identifier

NPI Name Address State City Identifier types that matches
1881895431 HOFER, CHRISTINA
Individual
2125 KNOLL DR CA VENTURA Identifier: HD743A (Medicare PIN)