Provider Demographics
NPI:1396256558
Name:CATHERINE MAYWOOD, M.D., A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:CATHERINE MAYWOOD, M.D., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-884-0660
Mailing Address - Street 1:1408 NAUTILUS ST
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-5636
Mailing Address - Country:US
Mailing Address - Phone:619-884-0660
Mailing Address - Fax:858-456-7071
Practice Address - Street 1:1940 EL CAJON BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-1005
Practice Address - Country:US
Practice Address - Phone:619-543-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty