Provider Demographics
NPI:1043387574
Name:WOMENS HEALTH & PREGNANCY CARE MEDICAL CENTER INC
Entity type:Organization
Organization Name:WOMENS HEALTH & PREGNANCY CARE MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:559-582-1045
Mailing Address - Street 1:440 GREENFIELD AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-3568
Mailing Address - Country:US
Mailing Address - Phone:559-582-1045
Mailing Address - Fax:559-582-2174
Practice Address - Street 1:440 GREENFIELD AVE
Practice Address - Street 2:SUITE D
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-3568
Practice Address - Country:US
Practice Address - Phone:559-582-1045
Practice Address - Fax:559-582-2174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG28470174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G284702Medicaid
CA96003852OtherCITY MUNICIPAL LICENCE #
CA11D0708894OtherCLIA WAIVER ID NUMBER
CAFNP 32069OtherFICTITIOUS NAME PERMIT #
CAFNP 32069OtherFICTITIOUS NAME PERMIT #
CA00G284702Medicaid
CA11D0708894OtherCLIA WAIVER ID NUMBER
CAZZZ24160ZMedicare ID - Type Unspecified