MEDICARE: CATHERINE GORCHOFF CNM

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	175M00000X	Lay Midwife	CNM653	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	ZZZ21677Z	OTHER	CA	MEDICARE PART B
4	05-1070	OTHER	CA	MEDICARE PART A

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
2	HAP71149F	OTHER	CA	FPACT

General Provider Information

NPI Number	:	1700911062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CATHERINE GORCHOFF CNM

Provider Business Mailing Address
First Line	:	1601 FRUITVALE AVE
Second Line	:
City	:	OAKLAND
State	:	CA
Zip	:	94601-2322
Country	:	US
Telephone Number	:	510-535-4000
Fax Number	:	510-535-4128

Provider Business Practice Location Address
First Line	:	210 HOSPITAL DRIVE
Second Line	:
City	:	VALLEJO
State	:	CA
Zip	:	84589
Country	:	US
Telephone Number	:	707-645-7316
Fax Number	:	707-645-0426

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

Provider Enumeration Date	:	02/23/2007
Last Update Date	:	01/13/2012

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Directions to “ CATHERINE GORCHOFF CNM” Practice Location

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