Provider Demographics
NPI:1225085798
Name:WOMEN'S HEALTH CARE CONSULTANTS MEDICAL GROUP, INCORPORATED
Entity Type:Organization
Organization Name:WOMEN'S HEALTH CARE CONSULTANTS MEDICAL GROUP, INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:YASSEAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-965-5500
Mailing Address - Street 1:6444 COYLE AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-0305
Mailing Address - Country:US
Mailing Address - Phone:916-536-5022
Mailing Address - Fax:916-965-9205
Practice Address - Street 1:6444 COYLE AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0305
Practice Address - Country:US
Practice Address - Phone:916-536-5022
Practice Address - Fax:916-965-9205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFNP 23343OtherFICTITIOUS NAME PERMIT
CA41610114OtherSTATE EMPLOYER NUMBER
CAD1928906OtherCALIFORNIA CORP NUMBER