Organization
DERMATOLOGY MEDICAL GROUP OF OXNARD AND CAMARILLO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACOB E LAU M.D. (MANAGING PARTNER)
(805) 983-0343
Entity
Organization
Contact information
Practice address
2811 N VENTURA RD, OXNARD, CA 93036-2213
(805) 983-0343
(805) 983-3285
Mailing address
2811 N VENTURA RD, OXNARD, CA 93036-2213
(805) 983-0343
(805) 983-3285
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CP2197
RAILROAD MEDICARE
—
Enumeration date
07/09/2006
Last updated
05/24/2011
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