MEDICARE: BIRGITTE U DAMGAARD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	LM 487	CA

General Provider Information

NPI Number	:	1184155715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BIRGITTE U DAMGAARD

Provider Business Mailing Address
First Line	:	24911 SAUSALITO ST
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-5627
Country	:	US
Telephone Number	:	949-280-3814
Fax Number	:

Provider Business Practice Location Address
First Line	:	24911 SAUSALITO ST
Second Line	:
City	:	LAGUNA HILLS
State	:	CA
Zip	:	92653-5627
Country	:	US
Telephone Number	:	949-280-3814
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2017
Last Update Date	:	03/24/2017

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