Provider Demographics
NPI:1093834533
Name:CENTURY WOMEN MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:CENTURY WOMEN MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:A
Authorized Official - Last Name:NASSIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-553-1200
Mailing Address - Street 1:8679 W PICO BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90035-2315
Mailing Address - Country:US
Mailing Address - Phone:310-553-1200
Mailing Address - Fax:310-553-1216
Practice Address - Street 1:8679 W PICO BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-2315
Practice Address - Country:US
Practice Address - Phone:310-553-1200
Practice Address - Fax:310-553-1216
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTURY WOMEN MEDICAL GROUP, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-28
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1821161860OtherNPI
CAGR0097002OtherMEDICAL GROUP NUMBER
CA1275619736OtherNPI