Provider Demographics
NPI:1770856478
Name:ASSOCIATED WOMEN'S HEALTHCARE OF THE INLAND VALLEY
Entity Type:Organization
Organization Name:ASSOCIATED WOMEN'S HEALTHCARE OF THE INLAND VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BYRNE
Authorized Official - Suffix:
Authorized Official - Credentials:M D, FACOG
Authorized Official - Phone:951-461-3311
Mailing Address - Street 1:25405 HANCOCK AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5978
Mailing Address - Country:US
Mailing Address - Phone:951-461-3311
Mailing Address - Fax:951-461-2833
Practice Address - Street 1:25405 HANCOCK AVE STE 101
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5978
Practice Address - Country:US
Practice Address - Phone:951-461-3311
Practice Address - Fax:951-461-2833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-12
Last Update Date:2012-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA39837207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty