Provider Demographics
NPI:1265157986
Name:SOUTH BAY OBGYN
Entity type:Organization
Organization Name:SOUTH BAY OBGYN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CATALANO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:619-267-8313
Mailing Address - Street 1:967 LANE AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914-4530
Mailing Address - Country:US
Mailing Address - Phone:619-267-8313
Mailing Address - Fax:619-472-2008
Practice Address - Street 1:967 LANE AVE STE 102
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914-4530
Practice Address - Country:US
Practice Address - Phone:619-267-8313
Practice Address - Fax:619-472-2008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherINSURANCE