Provider Demographics
NPI:1033959929
Name:DAUPHIN INTEGRATIVE GYNECOLOGY & WOMEN'S HEALTH
Entity type:Organization
Organization Name:DAUPHIN INTEGRATIVE GYNECOLOGY & WOMEN'S HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSELINE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:DAUPHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-397-5407
Mailing Address - Street 1:254 N LAKE AVE # 235
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-1829
Mailing Address - Country:US
Mailing Address - Phone:818-397-5407
Mailing Address - Fax:877-297-4486
Practice Address - Street 1:4955 VAN NUYS BLVD STE 306
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-1800
Practice Address - Country:US
Practice Address - Phone:818-843-6101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-29
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Multi-Specialty
No202D00000XAllopathic & Osteopathic PhysiciansIntegrative MedicineGroup - Multi-Specialty
No207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic SurgeryGroup - Multi-Specialty