Provider Demographics
NPI:1568557619
Name:GENERATIONS HEALTH CARE FOR WOMEN A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:GENERATIONS HEALTH CARE FOR WOMEN A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:CHAMBERLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:831-722-2473
Mailing Address - Street 1:202 GREEN VALLEY ROAD
Mailing Address - Street 2:
Mailing Address - City:FREEDOM
Mailing Address - State:CA
Mailing Address - Zip Code:95019-3135
Mailing Address - Country:US
Mailing Address - Phone:831-722-2473
Mailing Address - Fax:831-722-2067
Practice Address - Street 1:202 GREEN VALLEY ROAD
Practice Address - Street 2:
Practice Address - City:FREEDOM
Practice Address - State:CA
Practice Address - Zip Code:95019-3135
Practice Address - Country:US
Practice Address - Phone:831-722-2473
Practice Address - Fax:831-722-2067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC34605207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0070940Medicaid
CAA35673Medicare UPIN
CAGR0070940Medicaid