Provider Demographics
NPI:1871553347
Name:WOMAN TO WOMAN OB GYN MEDICAL GRP
Entity type:Organization
Organization Name:WOMAN TO WOMAN OB GYN MEDICAL GRP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:S
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-881-1683
Mailing Address - Street 1:249 E HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92404-3700
Mailing Address - Country:US
Mailing Address - Phone:909-881-1683
Mailing Address - Fax:909-881-4215
Practice Address - Street 1:249 E HIGHLAND AVE
Practice Address - Street 2:PATRICIA
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-3707
Practice Address - Country:US
Practice Address - Phone:909-883-0727
Practice Address - Fax:909-713-0388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG46150207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI14755Medicare UPIN
CA020A82040Medicare UPIN
CAA49018Medicare UPIN
CAA89829Medicare UPIN
CAI19663Medicare UPIN