Provider Demographics
NPI:1699086538
Name:CENTER FOR NATURAL BIRTH, LLC
Entity type:Organization
Organization Name:CENTER FOR NATURAL BIRTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MIDWIFE
Authorized Official - Prefix:MS
Authorized Official - First Name:GERRI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RYAN
Authorized Official - Suffix:
Authorized Official - Credentials:LM, CPM
Authorized Official - Phone:619-814-0567
Mailing Address - Street 1:4135 54TH PLACE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92105
Mailing Address - Country:US
Mailing Address - Phone:619-814-0567
Mailing Address - Fax:619-814-0569
Practice Address - Street 1:4135 54TH PL
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-2303
Practice Address - Country:US
Practice Address - Phone:619-814-0567
Practice Address - Fax:619-814-0569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA162176B00000X
CA155176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty