Provider Demographics
NPI:1689753295
Name:WOMENS HEALTH GROUP A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:WOMENS HEALTH GROUP A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:SHAPIRO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-756-4663
Mailing Address - Street 1:1850 SULLIVAN AVE
Mailing Address - Street 2:SUITE 312
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-2221
Mailing Address - Country:US
Mailing Address - Phone:650-756-4663
Mailing Address - Fax:650-756-2021
Practice Address - Street 1:1850 SULLIVAN AVE
Practice Address - Street 2:SUITE 312
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2221
Practice Address - Country:US
Practice Address - Phone:650-756-4663
Practice Address - Fax:650-756-2021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2015-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F00035OtherUPIN
CAGR0041950Medicaid
CAZZZ21841ZOtherMEDICARE
F00035OtherUPIN