Provider Demographics
NPI:1114322328
Name:MI BELLA BIRTH
Entity Type:Organization
Organization Name:MI BELLA BIRTH
Other - Org Name:MI BELLA BIRTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, MIDWIFE, CA LICENSED MIDWIFE
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLO
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:818-606-8076
Mailing Address - Street 1:27840 VILLA CANYON RD
Mailing Address - Street 2:
Mailing Address - City:CASTAIC
Mailing Address - State:CA
Mailing Address - Zip Code:91384-3732
Mailing Address - Country:US
Mailing Address - Phone:818-606-8076
Mailing Address - Fax:
Practice Address - Street 1:27840 VILLA CANYON RD
Practice Address - Street 2:
Practice Address - City:CASTAIC
Practice Address - State:CA
Practice Address - Zip Code:91384
Practice Address - Country:US
Practice Address - Phone:818-606-8076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA409282NW0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NW0100XHospitalsGeneral Acute Care HospitalWomen