MEDICARE: COASTAL WOMEN'S HEALTHCARE

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	207VX0000X	Obstetrics Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	DC1618	OTHER	CA	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1508907973
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COASTAL WOMEN'S HEALTHCARE

Provider Business Mailing Address
First Line	:	65 NEILSON ST
Second Line	:	STE 101
City	:	WATSONVILLE
State	:	CA
Zip	:	95076-2491
Country	:	US
Telephone Number	:	831-786-1457
Fax Number	:	831-786-1457

Provider Business Practice Location Address
First Line	:	65 NEILSON ST
Second Line	:	STE 101
City	:	WATSONVILLE
State	:	CA
Zip	:	95076-2491
Country	:	US
Telephone Number	:	831-786-1457
Fax Number	:	831-786-1457

Authorized Official
Title or Position	:	PRESIDENT
Name	:	CHERYL L NORTHEY
Credential	:	M.D.
Telephone Number	:	831-786-1457

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	08/22/2020

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Directions to “COASTAL WOMEN'S HEALTHCARE ” Practice Location

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