Provider Demographics
NPI:1427387430
Name:WOMEN'S PRIMARY HEALTH PHYSICIANS DIABLO VALLEY
Entity Type:Organization
Organization Name:WOMEN'S PRIMARY HEALTH PHYSICIANS DIABLO VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:SONDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-944-4837
Mailing Address - Street 1:4450 WALNUT BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-6132
Mailing Address - Country:US
Mailing Address - Phone:925-944-4837
Mailing Address - Fax:925-944-4841
Practice Address - Street 1:4450 WALNUT BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-6132
Practice Address - Country:US
Practice Address - Phone:925-944-4837
Practice Address - Fax:925-944-4841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-22
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty