Basic Information
| Provider Information | |||||||||
| NPI: | 1396256558 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CATHERINE MAYWOOD, M.D., A PROFESSIONAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1408 NAUTILUS ST | ||||||||
| Address2: | |||||||||
| City: | LA JOLLA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920375636 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6198840660 | ||||||||
| FaxNumber: | 8584567071 | ||||||||
| Practice Location | |||||||||
| Address1: | 1940 EL CAJON BLVD | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921041005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6195434500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/16/2017 | ||||||||
| LastUpdateDate: | 10/16/2017 | ||||||||
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| AuthorizedOfficialLastName: | MAYWOOD | ||||||||
| AuthorizedOfficialFirstName: | CATHERINE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 6198840660 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.