Basic Information
| Provider Information | |||||||||
| NPI: | 1225676620 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTER FOR MATERNAL FETAL HEALTH & HIGH RISK PREGNANCIES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8631 W 3RD ST STE 205 | ||||||||
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| City: | LOS ANGELES | ||||||||
| State: | CA | ||||||||
| PostalCode: | 900486168 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3102997561 | ||||||||
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| Practice Location | |||||||||
| Address1: | 16133 VENTURA BLVD STE 415 | ||||||||
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| City: | ENCINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 914362429 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3104207969 | ||||||||
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| ProviderEnumerationDate: | 12/16/2019 | ||||||||
| LastUpdateDate: | 12/16/2019 | ||||||||
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| AuthorizedOfficialLastName: | RAD | ||||||||
| AuthorizedOfficialFirstName: | STEVE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 3104207969 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 12/16/2019 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VM0101X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
No ID Information.