Provider Demographics
NPI:1699204552
Name:FIRST CHOICE WOMAN'S CLINIC, A PROFESSIONAL NURSING CORPORATION
Entity Type:Organization
Organization Name:FIRST CHOICE WOMAN'S CLINIC, A PROFESSIONAL NURSING CORPORATION
Other - Org Name:FCWC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:HAROUT
Authorized Official - Last Name:MAADANIAN
Authorized Official - Suffix:
Authorized Official - Credentials:CNM
Authorized Official - Phone:818-324-1227
Mailing Address - Street 1:8162 VAN NUYS BLVD
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-4806
Mailing Address - Country:US
Mailing Address - Phone:818-324-1227
Mailing Address - Fax:
Practice Address - Street 1:8162 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4806
Practice Address - Country:US
Practice Address - Phone:818-787-0060
Practice Address - Fax:818-787-0061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-05
Last Update Date:2017-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA235676207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty