Healthcare Provider Details

I. General information

NPI: 1376563445
Provider Name (Legal Business Name): PAUL A REHDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 11/07/2023
Certification Date: 11/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 N VENTURA RD
OXNARD CA
93036-2213
US

IV. Provider business mailing address

2811 N VENTURA RD
OXNARD CA
93036-2213
US

V. Phone/Fax

Practice location:
  • Phone: 805-983-0343
  • Fax: 805-983-3285
Mailing address:
  • Phone: 805-983-0343
  • Fax: 805-983-3285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License NumberG28511
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207NP0225X
TaxonomyPediatric Dermatology Physician
License NumberG28511
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License NumberG28511
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberG28511
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: