Provider Demographics
NPI:1699786293
Name:OB-GYN PLACE A MEDICAL CORPORATION
Entity type:Organization
Organization Name:OB-GYN PLACE A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SWAMINATHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-688-3584
Mailing Address - Street 1:622 W DUARTE RD STE 305
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-9281
Mailing Address - Country:US
Mailing Address - Phone:626-358-1970
Mailing Address - Fax:
Practice Address - Street 1:51 N 5TH AVE STE 204
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91006-3711
Practice Address - Country:US
Practice Address - Phone:626-358-1970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82019207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty