Preventive Women'S Health Care Medical Group, Inc

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

G54625 Issued in CA

Legal business name

PREVENTIVE WOMEN'S HEALTH CARE MEDICAL GROUP, INC

Practice address

7625 Mesa College Dr
101
San Diego, CA 92111-5343

Phone

(858) 277-1113

Fax

(858) 277-7639

NPI assigned

Jun 17, 2006

Organization subpart

No

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

Authorized official

Name

Rosalyn Patrice Baxter-Jones, M.D.

Title

Medical Director

Phone

(858) 277-1113

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1447295183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7625 MESA COLLEGE DR",
            "address_2": "101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921115343",
            "telephone_number": "858-277-1113",
            "fax_number": "858-277-7639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7625 MESA COLLEGE DR",
            "address_2": "101",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921115343",
            "telephone_number": "858-277-1113",
            "fax_number": "858-277-7639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE WOMEN'S HEALTH CARE MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAXTER-JONES",
        "authorized_official_first_name": "ROSALYN",
        "authorized_official_middle_name": "PATRICE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "858-277-1113",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "G54625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G546250",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Obstetrics & Gynecology Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Obstetrics & Gynecology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.