Provider Demographics
NPI:1659982130
Name:ANAYA WOMEN'S OB/GYN GROUP
Entity Type:Organization
Organization Name:ANAYA WOMEN'S OB/GYN GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:IOLA
Authorized Official - Last Name:HOLLINGSWORTH-MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-379-3108
Mailing Address - Street 1:18056 WIKA RD STE B
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2194
Mailing Address - Country:US
Mailing Address - Phone:760-813-3699
Mailing Address - Fax:
Practice Address - Street 1:18056 WIKA RD STE B
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2194
Practice Address - Country:US
Practice Address - Phone:760-813-3699
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-10
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty