MEDICARE: ARROWHEAD - OB-GYN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	C50030	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215915293
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARROWHEAD - OB-GYN

Provider Business Mailing Address
First Line	:	PO BOX 1570
Second Line	:
City	:	LAKE ARROWHEAD
State	:	CA
Zip	:	92352-1570
Country	:	US
Telephone Number	:	909-336-2156
Fax Number	:	909-336-0507

Provider Business Practice Location Address
First Line	:	29099 HOSPITAL RD
Second Line	:	STE 114
City	:	LAKE ARROWHEAD
State	:	CA
Zip	:	92352-1570
Country	:	US
Telephone Number	:	909-336-2156
Fax Number	:	909-336-0507

Authorized Official
Title or Position	:	PRESIDENT ARROWHEAD OB GYN
Name	:	DR. WILLIAM H DESCHNER
Credential	:	MD
Telephone Number	:	909-336-2156

Provider Enumeration Date	:	01/09/2006
Last Update Date	:	04/24/2009

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Directions to “ARROWHEAD - OB-GYN ” Practice Location

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