Organization
CENTURY WOMEN MEDICAL GROUP, INC
Active
Parent organization
CENTURY WOMEN MEDICAL GROUP, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTURY WOMEN MEDICAL GROUP, INC
Authorized official
DAVID CHRISTOPHER CASTRO (ADMINISTRATOR)
(310) 553-1200
Entity
Organization
Contact information
Practice address
2030 W PICO BLVD, LOS ANGELES, CA 90006-5011
(213) 389-4544
(213) 389-4554
Mailing address
8679 W PICO BLVD, LOS ANGELES, CA 90035-2315
(310) 553-1200
(310) 553-1216
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275619736
NPI
CA
05
—
1285753723
—
CA
01
—
1821161860
NPI
CA
05
—
GR0097000
—
CA
01
—
GR0097001
GROUP #
CA
Enumeration date
03/28/2007
Last updated
03/31/2021
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