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General NPI Number Information
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NPI Number | 1760812499
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Entity Type | Organization
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Legal Business Name | PACIFIC OB-GYN, MIDWIFERY & NURSING CORP
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Dates
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Enumeration Date | 11/15/2013
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Last Update Date | 01/26/2015
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Provider Practice Location Address
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Address Line | 3200 WALFORD AVE STE B
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City | EUREKA
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State | CA
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Zip | 95503-4828
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Country | US
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Telephone | 707-445-3443
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Fax | 707-445-1848
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Provider Business Mailing Address
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Address Line | 3200 WALFORD AVE # B
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City | EUREKA
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State | CA
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Zip | 95503-4828
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Country | US
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Telephone | 707-498-8022
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELIZABETH W O BRIEN
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Credential | NP, RN, NPF, MIDWIFE
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Telephone | 707-498-8022
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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 |
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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