Provider Demographics
NPI:1497839211
Name:OBSTETRICS & GYNECOLOGY SURGICAL ASSOCIATES
Entity Type:Organization
Organization Name:OBSTETRICS & GYNECOLOGY SURGICAL ASSOCIATES
Other - Org Name:WEST COAST OB/GYN, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:SAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-277-9378
Mailing Address - Street 1:7695 CARDINAL CT STE 240
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-3357
Mailing Address - Country:US
Mailing Address - Phone:858-277-9378
Mailing Address - Fax:858-277-9370
Practice Address - Street 1:8860 CENTER DR STE 360
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942
Practice Address - Country:US
Practice Address - Phone:858-277-9378
Practice Address - Fax:858-277-9370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2018-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG73947207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G739471Medicaid
CA00G739471Medicaid
CL089AMedicare PIN