Provider Demographics
NPI:1700935178
Name:WESTWIND WOMENS SERVICES MEDICAL GROUP
Entity Type:Organization
Organization Name:WESTWIND WOMENS SERVICES MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BURGER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:818-704-6696
Mailing Address - Street 1:22110 ROSCOE BLVD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91304-3845
Mailing Address - Country:US
Mailing Address - Phone:818-704-6696
Mailing Address - Fax:818-704-6896
Practice Address - Street 1:22110 ROSCOE BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91304-3845
Practice Address - Country:US
Practice Address - Phone:818-704-6696
Practice Address - Fax:818-704-6896
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAFNP 8981261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service