Provider Demographics
NPI:1467689430
Name:CENTER FOR WOMEN'S HEALTH AND FAMILY BIRTH
Entity Type:Organization
Organization Name:CENTER FOR WOMEN'S HEALTH AND FAMILY BIRTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAD
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-922-0481
Mailing Address - Street 1:210 S PALISADE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-5932
Mailing Address - Country:US
Mailing Address - Phone:805-922-0481
Mailing Address - Fax:805-925-5261
Practice Address - Street 1:210 S PALISADE DR STE 101
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5932
Practice Address - Country:US
Practice Address - Phone:805-922-0481
Practice Address - Fax:805-925-5261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-17
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA29996261Q00000X
CAA24996261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A249960Medicaid
CA00A249960Medicaid