Provider Demographics
NPI:1245469865
Name:PERINATOLOGY ASSOCIATES OF SAN DIEGO, INC
Entity type:Organization
Organization Name:PERINATOLOGY ASSOCIATES OF SAN DIEGO, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VALERIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CATANZARITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:858-939-6854
Mailing Address - Street 1:PO BOX 710206
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92171
Mailing Address - Country:US
Mailing Address - Phone:858-939-6880
Mailing Address - Fax:858-939-6808
Practice Address - Street 1:8010 FROST STREET
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123
Practice Address - Country:US
Practice Address - Phone:858-939-6880
Practice Address - Fax:858-939-6808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG26396207VM0101X
CAG80714207VM0101X
CAA63844207VM0101X
CAG47611207VM0101X
CAG87630207VM0101X
CAG46026207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G263960Medicaid
CA00G876300Medicaid
CA00G460260Medicaid
CA00A638440Medicaid
CA00G476110Medicaid
CA00G807140Medicaid
CAWG47611DMedicare UPIN
CA00G263960Medicaid
CA00G876300Medicaid
CA00A638440Medicaid
CAWG87630AMedicare UPIN
CA00G460260Medicaid