MEDICARE: GENERATIONS HEALTH CARE FOR WOMEN A MEDICAL CORPORATION

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	C34605	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	:	1568557619
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GENERATIONS HEALTH CARE FOR WOMEN A MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	202 GREEN VALLEY ROAD
Second Line	:
City	:	FREEDOM
State	:	CA
Zip	:	95019-3135
Country	:	US
Telephone Number	:	831-722-2473
Fax Number	:	831-722-2067

Provider Business Practice Location Address
First Line	:	202 GREEN VALLEY ROAD
Second Line	:
City	:	FREEDOM
State	:	CA
Zip	:	95019-3135
Country	:	US
Telephone Number	:	831-722-2473
Fax Number	:	831-722-2067

Authorized Official
Title or Position	:	OWNER
Name	:	DR. DENNIS JAMES CHAMBERLAIN
Credential	:	M.D.
Telephone Number	:	831-722-2473

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	12/10/2008

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