Provider Demographics
NPI:1407262777
Name:WESTRIDGE, OB/GYN
Entity Type:Organization
Organization Name:WESTRIDGE, OB/GYN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:HARNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-821-3610
Mailing Address - Street 1:2545 W FRYE RD STE 5
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-6273
Mailing Address - Country:US
Mailing Address - Phone:480-821-3610
Mailing Address - Fax:480-821-3610
Practice Address - Street 1:8410 W THOMAS RD STE 134
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-3374
Practice Address - Country:US
Practice Address - Phone:623-907-2377
Practice Address - Fax:480-821-3610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-08
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Multi-Specialty