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DERMATOLOGY MEDICAL GROUP OF OXNARD AND CAMARILLO NPI 1063606242


NPI Information

NPI: 1063606242
Provider Name: DERMATOLOGY MEDICAL GROUP OF OXNARD AND CAMARILLO
Classification: Dermatology - 207ND0900X
Entity Type: Organization

Specialization: Dermatopathology

Address:
500 PASEO CAMARILLO
SUITE 104
CAMARILLO, CA
ZIP 93010
Phone: (805) 482-4646
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DERMATOLOGY MEDICAL GROUP OF OXNARD AND CAMARILLO is a dermatopathology dermatology in Camarillo, CA. The provider is a dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. DERMATOLOGY MEDICAL GROUP OF OXNARD AND CAMARILLO NPI is 1063606242. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

500 PASEO CAMARILLO
SUITE 104
CAMARILLO, CA
ZIP 93010-900
Phone: (805) 482-4646
Fax: (805) 987-2533

The provider's authorized official is Jacob E. Lau .
The authorized official title is Managing Partner and has the following contact phone number (805) 482-4646.

The enumeration date for this NPI number is 8/30/2007 and was last updated on 5/24/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0900XDermatologyDermatopathologyA75621CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1W1120MEDICARE PIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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