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General NPI Number Information
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NPI Number | 1568648780
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Entity Type | Organization
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Legal Business Name | CITRUS OBSTETRICS &GYNECOLOGY MEDICAL ASSOCIATES INC
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Dates
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Enumeration Date | 01/17/2008
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Last Update Date | 08/01/2014
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Provider Practice Location Address
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Address Line | 1433 W MERCED AVE STE 103
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City | WEST COVINA
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State | CA
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Zip | 91790-3402
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Country | US
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Telephone | 626-337-8000
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Fax | 626-337-1145
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Provider Business Mailing Address
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Address Line | 1433 W MERCED AVE STE 103
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City | WEST COVINA
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State | CA
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Zip | 91790-3402
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Country | US
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Telephone | 626-337-8000
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Fax | 626-337-1145
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Authorized Official
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Title or Position | OWNER
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Name | MR. CARLOS S BEHARIE
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Credential | MD
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Telephone | 626-337-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G46446
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License Number State | CA
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