Provider Demographics
NPI:1447652524
Name:CAMPBELL, MOLLY (MD)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:
Last Name:CAMPBELL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:387 CIVIC DR
Mailing Address - Street 2:
Mailing Address - City:GALT
Mailing Address - State:CA
Mailing Address - Zip Code:95632-2059
Mailing Address - Country:US
Mailing Address - Phone:209-745-8080
Mailing Address - Fax:
Practice Address - Street 1:387 CIVIC DR
Practice Address - Street 2:
Practice Address - City:GALT
Practice Address - State:CA
Practice Address - Zip Code:95632-2059
Practice Address - Country:US
Practice Address - Phone:209-745-8080
Practice Address - Fax:209-745-8085
Is Sole Proprietor?:No
Enumeration Date:2014-09-21
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA158806207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology