MEDICARE: ALLIED WOMANS OBSTETRICS & GYNECOLOGY MEDICAL GROUP, 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	C41155	CA

General Provider Information

NPI Number	:	1538200118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIED WOMANS OBSTETRICS & GYNECOLOGY MEDICAL GROUP, INC.

Provider Business Mailing Address
First Line	:	800 FAIRMOUNT AVE STE 210
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-3152
Country	:	US
Telephone Number	:	626-584-6900
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 FAIRMOUNT AVE STE 210
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-3152
Country	:	US
Telephone Number	:	626-584-6900
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CLAUDETTE MCKENZIE-ALBIN
Credential	:	M.D.
Telephone Number	:	626-584-6900

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

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