Provider Demographics
NPI:1386770725
Name:GYNECOLOGIC ONCOLOGY SPECIALISTS PC
Entity type:Organization
Organization Name:GYNECOLOGIC ONCOLOGY SPECIALISTS PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:O
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-570-7799
Mailing Address - Street 1:315 MEIGS RD STE A334
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93109-1900
Mailing Address - Country:US
Mailing Address - Phone:805-570-7799
Mailing Address - Fax:
Practice Address - Street 1:2415 E MAIN ST
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2603
Practice Address - Country:US
Practice Address - Phone:805-869-6223
Practice Address - Fax:805-980-1742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW19249Medicare PIN