Provider Demographics
NPI:1376672048
Name:CENTRAL CALIFORNIA WOMENS HEALTH CARE
Entity Type:Organization
Organization Name:CENTRAL CALIFORNIA WOMENS HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSWALD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-261-9060
Mailing Address - Street 1:1929 FULTON ST
Mailing Address - Street 2:STE 102
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1093
Mailing Address - Country:US
Mailing Address - Phone:559-400-6270
Mailing Address - Fax:888-323-0590
Practice Address - Street 1:1929 FULTON ST
Practice Address - Street 2:STE 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1093
Practice Address - Country:US
Practice Address - Phone:559-400-6270
Practice Address - Fax:888-323-0590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization