Provider Demographics
NPI:1497180772
Name:MW HEALH ASSOCIATE INC
Entity Type:Organization
Organization Name:MW HEALH ASSOCIATE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PENKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-367-4741
Mailing Address - Street 1:901 SUNRISE AVE STE A22
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-4558
Mailing Address - Country:US
Mailing Address - Phone:916-367-4741
Mailing Address - Fax:
Practice Address - Street 1:901 SUNRISE AVE STE A22
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-4558
Practice Address - Country:US
Practice Address - Phone:916-367-4741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-05
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty