Provider Demographics
NPI:1457117665
Name:MAMA BIRTH & YONDER, LLC
Entity Type:Organization
Organization Name:MAMA BIRTH & YONDER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER OF MAMA BIRTH & YONDER, LLC
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:EMODI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-570-2540
Mailing Address - Street 1:1031 KOLEETA DR
Mailing Address - Street 2:
Mailing Address - City:HARBOR CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90710-1819
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1031 KOLEETA DR
Practice Address - Street 2:
Practice Address - City:HARBOR CITY
Practice Address - State:CA
Practice Address - Zip Code:90710-1819
Practice Address - Country:US
Practice Address - Phone:323-570-2540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty