MED CENTER MEDICAL CENTER
NPI 1417900788
Family Medicine in Simi Valley, CA

Q: What is Eastern Ventura Medical Group, Inc.'s NPI number?

The NPI number for Eastern Ventura Medical Group, Inc. is 1417900788. It was assigned to this organization in the NPPES registry on May 18, 2006. The provider is doing business as Med Center Medical Center.

Q: What is Eastern Ventura Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since May 18, 2006

1980 SEQUOIA AVE, SIMI VALLEY, CA 93063(805) 583-5555(805) 583-5554 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Jul 21, 2022, Jul 2, 2019 (2 updates tracked since 2019).

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About Med Center Medical Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MED CENTER MEDICAL CENTER (NPI 1417900788) is a healthcare organization registered as a family medicine in Simi Valley, California and active in the NPI registry since May 2006. The organization lists Denice Ruscigno, Administrator, as its authorized official.

NPPES Registry Identity

NPI1417900788

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameEASTERN VENTURA MEDICAL GROUP, INC.

Location Address1980 SEQUOIA AVESimi Valley, CA 93063-3167

Mailing Address1980 Sequoia AveSimi Valley, CA 93063-3167 · (805) 583-5555 · Fax (805) 583-5637

Phone(805) 583-5555

Fax(805) 583-5554

Organization SubpartNo

Authorized OfficialDenice RuscignoAdministrator · (805) 583-5555

Enumeration DateMay 18, 2006

Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration

✔ NPI 1417900788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

1980 SEQUOIA AVE, Simi Valley, CA 93063

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Other Names 1

Doing Business AsMed Center Medical Center

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0584090

Eastern Ventura Medical Group Inc · Simi Valley, CA

Expired · Sep 9, 2026

CLIA Number05D0584090

Laboratory TypeUrgent Care

Certificate Effective DateSeptember 10, 2024

Certificate Expiration DateSeptember 9, 2026

Laboratory DirectorWalter Thomas, MD

Laboratory Phone(805) 583-5555

Laboratory LocationEastern Ventura Medical Group Inc1980 Sequoia Avenue, Simi Valley, CA 93063

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARGARET SORIANO NURSE PRACTITIONER

Family Medicine