Genesis Womens Medical Group, Inc

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

A114893 Issued in CA

Legal business name

GENESIS WOMENS MEDICAL GROUP, INC

Practice address

502 Euclid Ave Ste 200
National City, CA 91950-2984

Phone

(619) 475-1261

Fax

(619) 475-1267

NPI assigned

Jun 25, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Abiade C Short, MD

Title

Vice President

Phone

(619) 475-1261

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379289600000",
    "number": "1295175180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 EUCLID AVE STE 200",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502984",
            "telephone_number": "619-475-1261",
            "fax_number": "619-475-1267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 EUCLID AVE STE 200",
            "city": "NATIONAL CITY",
            "state": "CA",
            "postal_code": "919502984",
            "telephone_number": "619-475-1261",
            "fax_number": "619-475-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS WOMENS MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-25",
        "last_updated": "2013-09-16",
        "status": "A",
        "authorized_official_last_name": "SHORT",
        "authorized_official_first_name": "ABIADE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "619-475-1261",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "A114893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gynecology Physician in National City, CA
• Providers in National City, CA by specialty
• Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.