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General NPI Number Information
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NPI Number | 1750314407
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Entity Type | Organization
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Legal Business Name | SOUTHBAY WOMENS MEDICAL CENTER INC
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 12/22/2008
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Provider Practice Location Address
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Address Line | 3590 E IMPERIAL HWY SUITE 5
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City | LYNWOOD
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State | CA
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Zip | 90262-2655
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Country | US
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Telephone | 310-631-4064
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Fax | 310-531-4246
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Provider Business Mailing Address
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Address Line | 3590 E IMPERIAL HWY SUITE 5
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City | LYNWOOD
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State | CA
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Zip | 90262-2655
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Country | US
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Telephone | 310-631-4064
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Fax | 310-531-4246
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Authorized Official
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Title or Position | OWNER
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Name | DR. PEDRO CEPEDA
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Credential | M.D.
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Telephone | 310-631-4064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VM0101X
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Taxonomy Name | Maternal & Fetal Medicine Physician
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License Number | G86266
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License Number State | CA
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