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General NPI Number Information
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NPI Number | 1114322328
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Entity Type | Organization
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Legal Business Name | MI BELLA BIRTH
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Dates
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Enumeration Date | 10/30/2014
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Last Update Date | 10/30/2014
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Provider Practice Location Address
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Address Line | 27840 VILLA CANYON RD
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City | CASTAIC
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State | CA
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Zip | 91384
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Country | US
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Telephone | 818-606-8076
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Fax |
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Provider Business Mailing Address
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Address Line | 27840 VILLA CANYON RD
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City | CASTAIC
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State | CA
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Zip | 91384-3732
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Country | US
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Telephone | 818-606-8076
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Fax |
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Authorized Official
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Title or Position | OWNER, MIDWIFE, CA LICENSED MIDWIFE
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Name | TIFFANY GALLO
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Credential | LM, CPM
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Telephone | 818-606-8076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NW0100X
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Taxonomy Name | Women's Hospital
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License Number | 409
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License Number State | CA
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