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General NPI Number Information
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NPI Number | 1699858555
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Entity Type | Organization
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Legal Business Name | PHOENIX WOMEN'S MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 10/07/2009
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Provider Practice Location Address
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Address Line | 555 E TACHEVAH DR #2E-103
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City | PALM SPRINGS
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State | CA
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Zip | 92262-5764
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Country | US
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Telephone | 760-320-1805
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Fax | 760-416-9301
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Provider Business Mailing Address
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Address Line | 555 E TACHEVAH DR SUITE #2E-103
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City | PALM SPRINGS
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State | CA
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Zip | 92262-5764
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Country | US
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Telephone | 760-320-1805
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Fax | 760-416-9301
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Authorized Official
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Title or Position | PRESIDENT/ OWNER
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Name | MS. MARGARET V COOPER VAUGHN
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Credential | M.D.
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Telephone | 760-320-1805
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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 | A87941
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License Number State | CA
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