Organization Active NPI

Mogens U Wiese MD Inc

  • Anesthesiology Physician
  • Thousand Oaks, CA
National Provider Identifier
1316955792
Registry record updated Nov 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A37380 Issued in CA
Legal business name
MOGENS U WIESE MD INC
Practice address
215 W Janss Rd
Thousand Oaks, CA 91360-1847
Phone
(310) 471-5852
Fax
(310) 471-3958
NPI assigned
Aug 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2009

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

Authorized official

Name
Mr. Mogens U. Wiese, M.D.
Title
Owner
Phone
(310) 471-5852

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X A37380 CA Primary

Addresses

Primary practice location

215 W Janss Rd
Thousand Oaks, CA 91360-1847

Mailing address

1633 Erringer Rd
1St Floor
Simi Valley, CA 93065-3583
Phone (805) 578-8300

Other identifiers 2

IdentifierTypeStateIssuer
GR0052481MedicaidCA
GR0052480MedicaidCA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258329600000",
    "number": "1316955792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1633 ERRINGER RD",
            "address_2": "1ST FLOOR",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653583",
            "telephone_number": "805-578-8300",
            "fax_number": "805-578-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 W JANSS RD",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913601847",
            "telephone_number": "310-471-5852",
            "fax_number": "310-471-3958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOGENS U WIESE MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2009-11-16",
        "status": "A",
        "authorized_official_last_name": "WIESE",
        "authorized_official_first_name": "MOGENS",
        "authorized_official_middle_name": "U.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-471-5852",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A37380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0052481",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0052480",
            "state": "CA"
        }
    ],
    "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 Nov 16, 2009; 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.