Provider Demographics
NPI:1124120985
Name:MAYHEW, ROSANNE (MD)
Entity type:Individual
Prefix:DR
First Name:ROSANNE
Middle Name:
Last Name:MAYHEW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 POLLARD RD STE. B203
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032
Mailing Address - Country:US
Mailing Address - Phone:408-871-1885
Mailing Address - Fax:408-871-8405
Practice Address - Street 1:800 POLLARD RD STE B203
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032
Practice Address - Country:US
Practice Address - Phone:408-871-1885
Practice Address - Fax:408-871-8405
Is Sole Proprietor?:No
Enumeration Date:2006-09-02
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA44044207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA44044OtherLICENSE #
CA05D0958937OtherCLIA #
CA77-0167661OtherTAX ID
CA77-0167661OtherTAX ID
CAA44044OtherLICENSE #