NPIMap

Organization Active NPI

Pacific Womens Obstetrics & Gynecology Medical Group Inc

  • Gynecology Physician
  • San Francisco, CA
National Provider Identifier
1417025545
Registry record updated Feb 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
PACIFIC WOMENS OBSTETRICS & GYNECOLOGY MEDICAL GROUP INC
Practice address
3838 California St
316
San Francisco, CA 94118-1522
Phone
(415) 379-9600
Fax
(415) 379-9823
NPI assigned
Nov 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2013

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

Authorized official

Name
Laurie Rae Green, M.D.NPI 1679641658
Title
Managing Physician
Phone
(415) 379-9600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207VG0400X CA Primary
Obstetrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207VX0000X CA

Addresses

Primary practice location

3838 California St
316
San Francisco, CA 94118-1522

Mailing address

3838 California St
316
San Francisco, CA 94118-1522
Phone (415) 379-9600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040317000964 CA Part B Supplier - Clinic/Group Practice 2961392527 Receives reassigned benefits from 8 practitioners
Practice locations: San Francisco, CA

National Provider Directory

National Provider Directory

Locations

3838 California St
Rm 316
San Francisco, CA 94118
Phone (415) 367-9500

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361318400000",
    "number": "1417025545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3838 CALIFORNIA ST",
            "address_2": "316",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941181522",
            "telephone_number": "415-379-9600",
            "fax_number": "415-379-9823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3838 CALIFORNIA ST",
            "address_2": "316",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941181522",
            "telephone_number": "415-379-9600",
            "fax_number": "415-379-9823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC WOMENS OBSTETRICS & GYNECOLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2013-02-20",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "MANAGING PHYSICIAN",
        "authorized_official_telephone_number": "415-379-9600",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.