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General NPI Number Information
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NPI Number | 1003657800
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Entity Type | Organization
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Legal Business Name | ERA WOMEN'S HEALTH, P.C.
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 11911 SAN VICENTE BLVD STE 265
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City | LOS ANGELES
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State | CA
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Zip | 90049-6634
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Country | US
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Telephone | 206-498-1074
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Fax |
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Provider Business Mailing Address
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Address Line | 578 WASHINGTON BLVD STE 722
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City | MARINA DEL REY
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State | CA
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Zip | 90292-5421
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Country | US
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Telephone | 206-498-1074
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHANIE MCCLELLAN
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Credential | MD
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Telephone | 949-933-6827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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