Provider Demographics
NPI:1669533477
Name:SINCERE HEALTHCARE FOR WOMEN A MEDICAL CORPORATION
Entity type:Organization
Organization Name:SINCERE HEALTHCARE FOR WOMEN A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER MD CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:626-792-4747
Mailing Address - Street 1:PO BOX 93457
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91109-3457
Mailing Address - Country:US
Mailing Address - Phone:626-792-4747
Mailing Address - Fax:626-441-6300
Practice Address - Street 1:1800 FAIR OAKS AVE
Practice Address - Street 2:SUITE C
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030
Practice Address - Country:US
Practice Address - Phone:626-792-4747
Practice Address - Fax:626-441-6300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG47927207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3526618Medicaid
A92776Medicare UPIN
A92776Medicare ID - Type Unspecified