Provider Demographics
NPI:1588011589
Name:THE NATURAL BIRTH PLACE INC
Entity type:Organization
Organization Name:THE NATURAL BIRTH PLACE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:ANGELA
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:909-567-2165
Mailing Address - Street 1:1881 BUSINESS CENTER DR
Mailing Address - Street 2:SUITE 8A
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3465
Mailing Address - Country:US
Mailing Address - Phone:184-452-0385
Mailing Address - Fax:
Practice Address - Street 1:1881 BUSINESS CENTER DR
Practice Address - Street 2:SUITE 8A
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-3465
Practice Address - Country:US
Practice Address - Phone:184-452-0385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-19
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthingGroup - Single Specialty
No163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic UltrasoundGroup - Single Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA12646542OtherCAQH PROVIDER ID