Active NPI
Dermatology Medical Group of Oxnard and Camarillo
- Dermatopathology Physician
- Camarillo, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatopathology Physician
- License
- A75621
- Legal business name
- DERMATOLOGY MEDICAL GROUP OF OXNARD AND CAMARILLO
- Practice address
- 500 Paseo Camarillo
Suite 104
Camarillo, CA 93010-5900 - Phone
- (805) 482-4646
- Fax
- (805) 987-2533
- NPI assigned
- Aug 30, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jacob E. Lau, M.D.
- Title
- Managing Partner
- Phone
- (805) 482-4646
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatopathology Physician | 207ND0900X | A75621 | CA | Primary |
Addresses
Primary practice location
500 Paseo Camarillo
Suite 104
Camarillo, CA 93010-5900
Mailing address
500 Paseo Camarillo
Suite 104
Camarillo, CA 93010-5900
Phone (805) 482-4646
National Provider Directory
National Provider Directory- Tax ID family
- Dermatology Medical Group of Oxnard and Camarillo
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dermatology Physician
- Oxnard, CA
- NPI 1871526145
Locations
500 Paseo Camarillo
Ste 104
Camarillo, CA 93010
Phone (805) 482-4646
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188432000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1306195200000",
"number": "1063606242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 PASEO CAMARILLO",
"address_2": "SUITE 104",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930105900",
"telephone_number": "805-482-4646",
"fax_number": "805-987-2533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 PASEO CAMARILLO",
"address_2": "SUITE 104",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930105900",
"telephone_number": "805-482-4646",
"fax_number": "805-987-2533"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DERMATOLOGY MEDICAL GROUP OF OXNARD AND CAMARILLO",
"organizational_subpart": "NO",
"enumeration_date": "2007-08-30",
"last_updated": "2011-05-24",
"status": "A",
"authorized_official_last_name": "LAU",
"authorized_official_first_name": "JACOB",
"authorized_official_middle_name": "E.",
"authorized_official_title_or_position": "MANAGING PARTNER",
"authorized_official_telephone_number": "805-482-4646",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207ND0900X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology, Dermatopathology",
"state": "CA",
"license": "A75621",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camarillo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.