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General NPI Number Information
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NPI Number | 1518030006
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Entity Type | Organization
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Legal Business Name | W A CENTER FOR WOMEN'S HEALTH
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 04/20/2011
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Provider Practice Location Address
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Address Line | 1007 LIVE OAK BLVD SUITE B2
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City | YUBA CITY
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State | CA
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Zip | 95991-3454
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Country | US
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Telephone | 530-713-5828
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Fax | 530-674-2744
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Provider Business Mailing Address
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Address Line | PO BOX 3666
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City | YUBA CITY
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State | CA
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Zip | 95992-3666
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Country | US
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Telephone | 530-713-5828
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Fax | 530-674-2744
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTOPHER GLEN GENOBAGA
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Credential | MD
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Telephone | 530-713-5828
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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 | A063752
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License Number State | CA
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