Provider Demographics
NPI:1124006838
Name:INGAGLIO, JAMES J (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:INGAGLIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 E DAILY DR STE 120
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6004
Mailing Address - Country:US
Mailing Address - Phone:805-256-7810
Mailing Address - Fax:805-256-7840
Practice Address - Street 1:1600 N ROSE AVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030
Practice Address - Country:US
Practice Address - Phone:805-988-2500
Practice Address - Fax:805-256-7810
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10674207V00000X
CAA66694207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100502055Medicaid
NV10674OtherMEDICAL LICENSE
NVCS12084OtherPHARMACY/CDS
NV10674OtherMEDICAL LICENSE
NVH24210Medicare UPIN