Basic Information
| Provider Information | |||||||||
| NPI: | 1952742694 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MID PENINSULA HEALTHCARE INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 401 WARREN ST | ||||||||
| Address2: | 300 | ||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940631578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503659997 | ||||||||
| FaxNumber: | 6503659782 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 WARREN ST | ||||||||
| Address2: | 300 | ||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940631578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503659997 | ||||||||
| FaxNumber: | 6503659782 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2013 | ||||||||
| LastUpdateDate: | 07/10/2013 | ||||||||
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| AuthorizedOfficialLastName: | PARSA | ||||||||
| AuthorizedOfficialFirstName: | MOHAMAD | ||||||||
| AuthorizedOfficialMiddleName: | ALI | ||||||||
| AuthorizedOfficialTitleorPosition: | AUTHORIZED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 6503659997 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.