NPIMap

Organization Active NPI

Los Robles Pediatric Medical Group, Inc.

  • Pediatrics Physician
  • Thousand Oaks, CA
National Provider Identifier
1013919208
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A22017 Issued in CA
Legal business name
LOS ROBLES PEDIATRIC MEDICAL GROUP, INC.
Practice address
299 W Hillcrest Dr
Ste 100
Thousand Oaks, CA 91360-7820
Phone
(805) 497-7888
Fax
(805) 494-3498
NPI assigned
Jun 1, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael Gollub, M.D.NPI 1881723351
Title
President
Phone
(805) 497-7888

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A22017 CA Primary

Addresses

Primary practice location

299 W Hillcrest Dr
Ste 100
Thousand Oaks, CA 91360-7820

Mailing address

299 W Hillcrest Dr
Ste 100
Thousand Oaks, CA 91360-7820
Phone (805) 497-7888

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013919208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "299 W HILLCREST DR",
            "address_2": "STE 100",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913607820",
            "telephone_number": "805-497-7888",
            "fax_number": "805-494-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "299 W HILLCREST DR",
            "address_2": "STE 100",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913607820",
            "telephone_number": "805-497-7888",
            "fax_number": "805-494-3498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ROBLES PEDIATRIC MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GOLLUB",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "805-497-7888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A22017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.