Provider Demographics
NPI:1881791317
Name:OB-GYN PARTNERS FOR HEALTH MEDICAL GROUP INC
Entity type:Organization
Organization Name:OB-GYN PARTNERS FOR HEALTH MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:JACOBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-893-1700
Mailing Address - Street 1:365 HAWTHORNE AVE #301
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94609-3113
Mailing Address - Country:US
Mailing Address - Phone:510-893-1700
Mailing Address - Fax:510-893-0110
Practice Address - Street 1:365 HAWTHORNE AVE #301
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3113
Practice Address - Country:US
Practice Address - Phone:510-893-1700
Practice Address - Fax:510-893-0110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ14102ZMedicare ID - Type Unspecified