Provider Demographics
NPI:1578860060
Name:FOR WOMEN BY WOMEN A MEDICAL GROUP A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:FOR WOMEN BY WOMEN A MEDICAL GROUP A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYHEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-871-1885
Mailing Address - Street 1:PO BOX 320963
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-0116
Mailing Address - Country:US
Mailing Address - Phone:408-871-1885
Mailing Address - Fax:
Practice Address - Street 1:555 KNOWLES DR
Practice Address - Street 2:SUITE 218
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1549
Practice Address - Country:US
Practice Address - Phone:408-871-1885
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-17
Last Update Date:2015-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty