| Conejo Oaks Medical Group Inc | |
|
2100 Lynn Rd Ste 215 Thousand Oaks CA 91360-8038 | |
| (805) 497-4974 | |
| (805) 496-7636 |
| Full Name | Conejo Oaks Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 2100 Lynn Rd Ste 215, Thousand Oaks, California |
| Authorized Official Name and Position | Francis M. Dawson (PROVIDER) |
| Authorized Official Contact | 8054974974 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conejo Oaks Medical Group Inc 2100 Lynn Rd Ste 215 Thousand Oaks CA 91360-8038 Ph: (805) 497-4974 | Conejo Oaks Medical Group Inc 2100 Lynn Rd Ste 215 Thousand Oaks CA 91360-8038 Ph: (805) 497-4974 |
| NPI Number | 1477640464 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 06/21/2018 |
| Medicare PECOS PAC ID | 7517981731 |
|---|---|
| Medicare Enrollment ID | O20060113000941 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477640464 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G33376 (California) | Secondary |
| 207Q00000X | Family Medicine | G32734 (California) | Primary |
| Provider Name | Francis M Dawson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043390883 PECOS PAC ID: 2062436280 Enrollment ID: I20120130000691 |
| Provider Name | Paul C Reisser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306926142 PECOS PAC ID: 1355501941 Enrollment ID: I20120319000388 |
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