Provider Demographics
NPI:1720080682
Name:TAMURA, BRIAN H (MD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:H
Last Name:TAMURA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1100 N VENTURA RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-3841
Mailing Address - Country:US
Mailing Address - Phone:805-983-0897
Mailing Address - Fax:805-981-9587
Practice Address - Street 1:1100 N VENTURA RD
Practice Address - Street 2:SUITE 105
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93030-3841
Practice Address - Country:US
Practice Address - Phone:805-983-0897
Practice Address - Fax:805-981-9587
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-11
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG14936207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG14936Medicare UPIN
CAA39388Medicare UPIN