Basic Information
| Provider Information | |||||||||
| NPI: | 1679900401 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CALIFORNIA FERTILITY EXPERTS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 13768 ROSWELL AVE | ||||||||
| Address2: | SUITE 207 | ||||||||
| City: | CHINO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917101401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095912229 | ||||||||
| FaxNumber: | 8182467265 | ||||||||
| Practice Location | |||||||||
| Address1: | 4910 DIRECTORS PL | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921213811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8553606730 | ||||||||
| FaxNumber: | 8586305552 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2013 | ||||||||
| LastUpdateDate: | 10/13/2013 | ||||||||
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| AuthorizedOfficialLastName: | XU | ||||||||
| AuthorizedOfficialFirstName: | JAY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8553606730 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 291U00000X | B2013056004 | CA | Y | Laboratories | Clinical Medical Laboratory |
No ID Information.