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CONEJO MEDICAL & BEAST CARE CENTER NPI 1922155191


NPI Information

NPI: 1922155191
Provider Name: CONEJO MEDICAL & BEAST CARE CENTER
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D0559475

Address:
3180 WILLOW LN
200
THOUSAND OAKS, CA
ZIP 91361
Phone: (805) 497-3239
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CONEJO MEDICAL & BEAST CARE CENTER is a family medicine in Thousand Oaks, CA. The provider is 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. CONEJO MEDICAL & BEAST CARE CENTER NPI is 1922155191. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3180 WILLOW LN
200
THOUSAND OAKS, CA
ZIP 91361-941
Phone: (805) 497-3239
Fax: (805) 497-3110

The provider's authorized official is Maureen Malone .
The authorized official title is Front Office Manager and has the following contact phone number (805) 497-3239.

The CLIA number assigned to this NPI record is 05D0559475 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/3/2007 and was last updated on 8/22/2020.


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
1207Q00000XFamily MedicineA63292CALIFORNIAYes
2207R00000XInternal MedicineA41849CALIFORNIAX
3207RG0100XInternal MedicineGastroenterologyG73949CALIFORNIAX
4208600000XSurgeryA39905CALIFORNIAX
5208D00000XGeneral PracticeG50708CALIFORNIAX

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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