MEDICARE: THE WOMAN'S PLACE FOR HEALTH, INC.

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	207V00000X	Obstetrics & Gynecology Physician	G52027	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336213230
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE WOMAN'S PLACE FOR HEALTH, INC.

Provider Business Mailing Address
First Line	:	3901 LAS POSAS RD
Second Line	:	SUITE 207
City	:	CAMARILLO
State	:	CA
Zip	:	93010-1506
Country	:	US
Telephone Number	:	805-987-6807
Fax Number	:	805-987-9197

Provider Business Practice Location Address
First Line	:	3901 LAS POSAS RD
Second Line	:	SUITE 207
City	:	CAMARILLO
State	:	CA
Zip	:	93010-1506
Country	:	US
Telephone Number	:	805-987-6807
Fax Number	:	805-987-9197

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MS. JUDY HARRISON
Credential	:
Telephone Number	:	805-987-6807

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	06/20/2008

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