Provider Demographics
NPI:1164179230
Name:AA MIDWIFERY CENTER
Entity Type:Organization
Organization Name:AA MIDWIFERY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MIDWIFE/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNGUIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-306-7278
Mailing Address - Street 1:5535 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-2611
Mailing Address - Country:US
Mailing Address - Phone:909-306-7278
Mailing Address - Fax:
Practice Address - Street 1:5535 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-2611
Practice Address - Country:US
Practice Address - Phone:909-306-7278
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-08
Last Update Date:2022-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing