Provider Demographics
NPI:1962690669
Name:WOMENS HEALTH AND REPRODUCTIVE CENTER A MEDICAL GROUP INC
Entity type:Organization
Organization Name:WOMENS HEALTH AND REPRODUCTIVE CENTER A MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:KIZNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:562-431-3606
Mailing Address - Street 1:10861 CHERRY ST.
Mailing Address - Street 2:SUITE 109
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-5400
Mailing Address - Country:US
Mailing Address - Phone:562-431-3606
Mailing Address - Fax:562-430-5975
Practice Address - Street 1:10861 CHERRY ST.
Practice Address - Street 2:SUITE 109
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-5400
Practice Address - Country:US
Practice Address - Phone:562-431-3606
Practice Address - Fax:562-430-5975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2014-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG70386207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty