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General NPI Number Information
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NPI Number | 1922155191
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Entity Type | Organization
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Legal Business Name | CONEJO MEDICAL & BEAST CARE CENTER
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3180 WILLOW LN 200
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City | THOUSAND OAKS
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State | CA
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Zip | 91361-4941
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Country | US
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Telephone | 805-497-3239
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Fax | 805-497-3110
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Provider Business Mailing Address
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Address Line | 3180 WILLOW LN 200
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City | THOUSAND OAKS
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State | CA
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Zip | 91361-4941
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Country | US
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Telephone | 805-497-3239
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Fax | 805-497-3110
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Authorized Official
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Title or Position | FRONT OFFICE MANAGER
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Name | MAUREEN MALONE
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Credential |
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Telephone | 805-497-3239
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A63292
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A41849
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | G73949
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A39905
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | G50708
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License Number State | CA
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