Basic Information
| Provider Information | |||||||||
| NPI: | 1598093502 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | IN VITROTECH LABS, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9301 WILSHIRE BLVD STE 313 | ||||||||
| Address2: | |||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902106131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105501951 | ||||||||
| FaxNumber: | 3105501971 | ||||||||
| Practice Location | |||||||||
| Address1: | 9301 WILSHIRE BLVD STE 313 | ||||||||
| Address2: | |||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 902106131 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3105501951 | ||||||||
| FaxNumber: | 3105501971 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/02/2009 | ||||||||
| LastUpdateDate: | 12/02/2009 | ||||||||
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| AuthorizedOfficialLastName: | MOR | ||||||||
| AuthorizedOfficialFirstName: | ELIRAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHAIRMAN | ||||||||
| AuthorizedOfficialTelephone: | 8189071571 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | 85787 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.