Provider Demographics
NPI: | 1487896239 |
---|---|
Name: | O'MALLEY, KATHARINE NEWMAN (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | KATHARINE |
Middle Name: | NEWMAN |
Last Name: | O'MALLEY |
Suffix: | |
Gender: | F |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | KATHARINE |
Other - Middle Name: | B |
Other - Last Name: | NEWMAN |
Other - Suffix: | |
Other - Last Name Type: | Other Name |
Other - Credentials: | MD |
Mailing Address - Street 1: | PO BOX 276950 |
Mailing Address - Street 2: | |
Mailing Address - City: | SACRAMENTO |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 95827-6950 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2495 HOSPITAL DR STE 400 |
Practice Address - Street 2: | |
Practice Address - City: | MOUNTAIN VIEW |
Practice Address - State: | CA |
Practice Address - Zip Code: | 94040-4157 |
Practice Address - Country: | US |
Practice Address - Phone: | 650-404-8210 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2009-03-25 |
Last Update Date: | 2024-12-03 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | A125125 | 207V00000X, 207VM0101X |
390200000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207VM0101X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | |
No | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |