Healthcare Provider Details

I. General information

NPI: 1285446773
Provider Name (Legal Business Name): LIFE IVF CENTER LOS ANGELES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2025
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

289 W HUNTINGTON DR STE 400
ARCADIA CA
91007-3495
US

IV. Provider business mailing address

3500 BARRANCA PKWY STE 300
IRVINE CA
92606-8232
US

V. Phone/Fax

Practice location:
  • Phone: 626-777-1133
  • Fax:
Mailing address:
  • Phone: 949-788-1133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0006X
TaxonomyAmbulatory Fertility Facility
License Number
License Number State

VIII. Authorized Official

Name: BENJAMIN H YELIAN
Title or Position: DIRECTOR
Credential:
Phone: 949-788-1133