Healthcare Provider Details

I. General information

NPI: 1992967301
Provider Name (Legal Business Name): EAST BAY FERTILITY CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 07/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7567 AMADOR VALLEY BLVD SUITE 308
DUBLIN CA
94568-2441
US

IV. Provider business mailing address

7567 AMADOR VALLEY BLVD SUITE 308
DUBLIN CA
94568-2441
US

V. Phone/Fax

Practice location:
  • Phone: 925-828-9235
  • Fax: 925-828-3540
Mailing address:
  • Phone: 925-828-9235
  • Fax: 925-828-3540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberC50122
License Number StateCA

VIII. Authorized Official

Name: DR. ELLEN U. SNOWDEN
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 925-828-9235