Healthcare Provider Details

I. General information

NPI: 1568499408
Provider Name (Legal Business Name): SOUTHERN CALIFORNIA WOMENS HEALTH GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 N CENTRAL AVE STE 201
GLENDALE CA
91203-1901
US

IV. Provider business mailing address

PO BOX 16376
BEVERLY HILLS CA
90209-2376
US

V. Phone/Fax

Practice location:
  • Phone: 818-265-9499
  • Fax: 818-548-0447
Mailing address:
  • Phone: 818-265-9499
  • Fax: 818-548-0447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL TAHERY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 818-265-9499