Organization
BIRTH WAVES MIDWIFERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TATIANA KOONTZ LM, CPM (OWNER)
(858) 221-6040
Entity
Organization
Contact information
Practice address
3830 VALLEY CENTRE DR # 705-246, SAN DIEGO, CA 92130-3320
(858) 221-6040
Mailing address
3830 VALLEY CENTRE DR # 705-246, SAN DIEGO, CA 92130-3320
(858) 221-6040
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
—
—
Other
Enumeration date
03/28/2019
Last updated
03/28/2019
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