Provider Demographics
NPI:1083638332
Name:WEST, NANCY LYNN (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:LYNN
Last Name:WEST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 255228
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95865-5228
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:3280 PROFESSIONAL DR
Practice Address - Street 2:SUITE A
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95602-2491
Practice Address - Country:US
Practice Address - Phone:530-885-2186
Practice Address - Fax:530-885-2180
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG55309207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G553090Medicaid
CA00G553090Medicaid