Healthcare Provider Details
I. General information
NPI: 1851804819
Provider Name (Legal Business Name): FERTILITY CENTERS OF ORANGE COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/13/2017
Last Update Date: 12/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 ALTON PKWY STE 201
IRVINE CA
92606-5034
US
IV. Provider business mailing address
13950 MILTON AVE STE 402
WESTMINSTER CA
92683-2939
US
V. Phone/Fax
- Phone: 949-387-3888
- Fax:
- Phone: 714-702-3000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VE0102X |
| Taxonomy | Reproductive Endocrinology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MIKE
RITCHEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 714-702-3000