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General NPI Number Information
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NPI Number | 1790640936
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Entity Type | Organization
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Legal Business Name | MATERNAL HEALTH MEDICAL GROUP LLC
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Dates
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Enumeration Date | 12/19/2025
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 8690 AERO DR
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City | SAN DIEGO
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State | CA
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Zip | 92123-1886
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Country | US
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Telephone | 619-608-1488
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Fax |
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Provider Business Mailing Address
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Address Line | 1125 E BROADWAY # 2242
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City | GLENDALE
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State | CA
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Zip | 91205-1315
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BOARD MEMBER
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Name | JADE STORMS
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Credential |
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Telephone | 310-403-4886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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