Provider Demographics
NPI:1962023366
Name:BIRTHLAND MIDWIFERY
Entity Type:Organization
Organization Name:BIRTHLAND MIDWIFERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANJALI
Authorized Official - Middle Name:
Authorized Official - Last Name:SARDESHMUKH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-394-2203
Mailing Address - Street 1:486 49TH ST # C
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-2178
Mailing Address - Country:US
Mailing Address - Phone:510-394-2203
Mailing Address - Fax:
Practice Address - Street 1:486 49TH ST # C
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-2178
Practice Address - Country:US
Practice Address - Phone:510-394-2203
Practice Address - Fax:510-740-4474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA100122829Medicaid