Organization
CONEJO LOS ROBLES ANESTHESIOLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MOGENS WIESE M.D. (MEDICAL DIRECTOR)
(805) 370-4521
Entity
Organization
Contact information
Practice address
215 W JANSS RD, THOUSAND OAKS, CA 91360-1847
(805) 370-4521
Mailing address
PO BOX 10076, VAN NUYS, CA 91410-0076
(805) 578-8300
(805) 578-8950
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
10/23/2006
Last updated
10/02/2007
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