NPIMap

Organization Active NPI

Womens Health Medical Group

  • Obstetrics & Gynecology Physician
  • Glendale, CA
National Provider Identifier
1487753216
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
WOMENS HEALTH MEDICAL GROUP
Practice address
3469 N Verdugo Rd
Glendale, CA 91208
Phone
(818) 249-6636
Fax
(818) 249-5074
NPI assigned
Sep 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Kolleen Obannon Squires, CNP
Title
Nurse Practitioner
Phone
(818) 249-6636

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

3469 N Verdugo Rd
Glendale, CA 91208

Mailing address

3469 N Verdugo Rd
Glendale, CA 91208
Phone (818) 249-6636

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487753216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3469 N VERDUGO RD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91208",
            "telephone_number": "818-249-6636",
            "fax_number": "818-249-5074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3469 N VERDUGO RD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "91208",
            "telephone_number": "818-249-6636",
            "fax_number": "818-249-5074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOMENS HEALTH MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OBANNON SQUIRES",
        "authorized_official_first_name": "KOLLEEN",
        "authorized_official_title_or_position": "NURSE PRACTITIONER",
        "authorized_official_telephone_number": "818-249-6636",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • 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.