Conejo Dermatology Medical Group

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

CONEJO DERMATOLOGY MEDICAL GROUP

Practice address

55 Rolling Oaks Dr # 200
Thousand Oaks, CA 91361-1010

Phone

(805) 497-7529

Fax

(805) 494-3486

NPI assigned

Aug 10, 2006

Last updated

Jan 11, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ralph M Kamell, MDNPI 1881609741

Title

Managing Partner

Phone

(805) 497-7529

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners 2

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.

• Ralph M Kamell, MD

  • Dermatology Physician
  • Thousand Oaks, CA
  • NPI 1881609741
  Authorized official Same address or phone
• Marina Forte, NP

  • Nurse Practitioner
  • Sonoma, CA
  • NPI 1356013049
  NPD

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515628800000",
    "number": "1073524674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 ROLLING OAKS DR",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611010",
            "telephone_number": "805-497-7529",
            "fax_number": "805-494-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 ROLLING OAKS DR # 200",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913611010",
            "telephone_number": "805-497-7529",
            "fax_number": "805-494-3486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONEJO DERMATOLOGY MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2018-01-11",
        "status": "A",
        "authorized_official_last_name": "KAMELL",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "805-497-7529",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.