Paul L. Dudley, M.D., a Medical Corporation

Primary specialty

SpecialistTaxonomy code 174400000X

License

G25705 Issued in CA

Legal business name

PAUL L. DUDLEY, M.D., A MEDICAL CORPORATION

Practice address

2220 Lynn Rd Ste 206
Thousand Oaks, CA 91360-8007

Phone

(805) 497-0027

Fax

(805) 497-0147

NPI assigned

Feb 26, 2007

Organization subpart

No

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

Authorized official

Name

Tiffany Sheehan

Title

Billing Manager

Phone

(805) 497-0027

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1396871125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2220 LYNN RD STE 206",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913608007",
            "telephone_number": "805-497-0027",
            "fax_number": "805-497-0147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2220 LYNN RD STE 206",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913608007",
            "telephone_number": "805-497-0027",
            "fax_number": "805-497-0147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL L. DUDLEY, M.D., A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "SHEEHAN",
        "authorized_official_first_name": "TIFFANY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "805-497-0027"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G25705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G257050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Thousand Oaks, CA
• Providers in Thousand Oaks, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.