Provider Demographics
NPI:1386286979
Name:CALIFORNIA MATERNAL FETAL MEDICINE INC
Entity type:Organization
Organization Name:CALIFORNIA MATERNAL FETAL MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-603-5600
Mailing Address - Street 1:1645 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-3832
Mailing Address - Country:US
Mailing Address - Phone:916-603-5600
Mailing Address - Fax:
Practice Address - Street 1:100 HOWE AVE STE 186N
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-8219
Practice Address - Country:US
Practice Address - Phone:916-603-5600
Practice Address - Fax:855-815-4684
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-15
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1386286979OtherNPI