Organization
INFINITE WOMEN'S CARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIAUTAUD M PROPHETE D.O. (PHYSICIAN)
(209) 826-4771
Entity
Organization
Contact information
Practice address
600 W I ST STE C, LOS BANOS, CA 93635-3460
(209) 826-4771
(209) 826-8565
Mailing address
600 W I ST STE C, LOS BANOS, CA 93635-3460
(209) 826-4771
(209) 826-8565
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
20A13319
CA
207V00000X
Obstetrics & Gynecology Physician
Primary
20A9842
CA
207V00000X
Obstetrics & Gynecology Physician
G816740
CA
Other
Enumeration date
09/08/2014
Last updated
09/08/2014
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