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General NPI Number Information
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NPI Number | 1851498935
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Entity Type | Organization
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Legal Business Name | CONEJO MEDICAL GROUP FOR WOMEN
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2190 LYNN RD STE 290
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-8023
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Country | US
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Telephone | 805-496-9659
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Fax | 805-496-1460
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Provider Business Mailing Address
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Address Line | 2190 LYNN RD STE 290
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-8023
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Country | US
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Telephone | 805-496-9659
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Fax | 805-496-1460
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Authorized Official
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Title or Position | SEC
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Name | PAUL HENRI TOOMER,M.D.
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Credential | M.D.
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Telephone | 805-496-9659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C35879
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License Number State | CA
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