Provider Demographics
NPI:1487134359
Name:PREMIER WOMEN'S CARE INC
Entity type:Organization
Organization Name:PREMIER WOMEN'S CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:EDMOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-659-4564
Mailing Address - Street 1:8737 BEVERLY BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90048-1840
Mailing Address - Country:US
Mailing Address - Phone:310-659-4564
Mailing Address - Fax:310-854-1035
Practice Address - Street 1:8737 BEVERLY BLVD STE 201
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1840
Practice Address - Country:US
Practice Address - Phone:310-659-4564
Practice Address - Fax:310-854-1035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91799207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty