Provider Demographics
NPI:1699739086
Name:OBGYN AFFILIATES MEDICAL GROUP
Entity type:Organization
Organization Name:OBGYN AFFILIATES MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-348-6200
Mailing Address - Street 1:7345 MEDICAL CENTER DR
Mailing Address - Street 2:#500
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307
Mailing Address - Country:US
Mailing Address - Phone:818-248-6200
Mailing Address - Fax:818-348-0819
Practice Address - Street 1:7345 MEDICAL CENTER DR
Practice Address - Street 2:#500
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307
Practice Address - Country:US
Practice Address - Phone:818-348-6200
Practice Address - Fax:818-348-0819
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG36512207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A91791Medicare UPIN
W10206Medicare ID - Type Unspecified