| Guardiant Health | |
|
2485 Ventura Blvd Camarillo CA 93010-6650 | |
| (805) 364-0889 | |
| (805) 200-4434 |
| Full Name | Guardiant Health |
|---|---|
| Speciality | Family Medicine |
| Location | 2485 Ventura Blvd, Camarillo, California |
| Authorized Official Name and Position | Kurt Tamaru (CEO) |
| Authorized Official Contact | 7073655178 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Guardiant Health 2485 Ventura Blvd Camarillo CA 93010-6650 Ph: (707) 356-5178 | Guardiant Health 2485 Ventura Blvd Camarillo CA 93010-6650 Ph: (805) 364-0889 |
| NPI Number | 1386240034 |
|---|---|
| Provider Enumeration Date | 12/08/2020 |
| Last Update Date | 10/06/2025 |
| Certification Date | 10/06/2025 |
| Medicare PECOS PAC ID | 5092129528 |
|---|---|
| Medicare Enrollment ID | O20210125002282 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386240034 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 207R00000X | Internal Medicine | () | Secondary |
| 261Q00000X | Clinic/center | () | Secondary |
| Provider Name | Kurt M Tamaru |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134167356 PECOS PAC ID: 2163451097 Enrollment ID: I20050810000840 |
| Provider Name | Marie Nelsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033140884 PECOS PAC ID: 3870683022 Enrollment ID: I20071212000413 |
| Provider Name | Jevon C Mitsuoka |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215928171 PECOS PAC ID: 7517172588 Enrollment ID: I20180413001606 |
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