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General NPI Number Information
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NPI Number | 1396883104
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Entity Type | Organization
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Legal Business Name | WOMEN'S HEALTHCARE ASSOCIATES OF SANTA MONICA, A MEDICAL CORPORATION
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 06/25/2018
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Provider Practice Location Address
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Address Line | 1245 16TH ST #300
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City | SANTA MONICA
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State | CA
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Zip | 90404
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Country | US
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Telephone | 310-453-6767
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Fax | 310-586-0809
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Provider Business Mailing Address
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Address Line | 1245 16TH ST #300
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City | SANTA MONICA
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State | CA
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Zip | 90404-1235
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Country | US
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Telephone | 310-453-6767
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Fax | 310-586-0809
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DORON BLUMENFELD
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Credential | M.D.
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Telephone | 310-453-6767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | CA
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