Provider Demographics
NPI:1144694720
Name:VENTURA ASC LLC
Entity type:Organization
Organization Name:VENTURA ASC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:SHAWN
Authorized Official - Last Name:SKILLERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:805-643-3330
Mailing Address - Street 1:100 N BRENT ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2822
Mailing Address - Country:US
Mailing Address - Phone:805-643-3330
Mailing Address - Fax:
Practice Address - Street 1:100 N BRENT ST
Practice Address - Street 2:SUITE 201
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-2822
Practice Address - Country:US
Practice Address - Phone:805-643-3330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST COAST VASCULAR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-11-19
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical