Healthcare Provider Details

I. General information

NPI: 1407976996
Provider Name (Legal Business Name): CALIFORNIA FERTILITY PARTNERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2007
Last Update Date: 04/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11818 WILSHIRE BLVD SUITE 300
LOS ANGELES CA
90025-6646
US

IV. Provider business mailing address

11818 WILSHIRE BLVD SUITE 300
LOS ANGELES CA
90025-6646
US

V. Phone/Fax

Practice location:
  • Phone: 310-828-4008
  • Fax: 310-828-3310
Mailing address:
  • Phone: 310-828-4008
  • Fax: 310-828-3310

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL SIKICH
Title or Position: ADMINISTRATOR
Credential:
Phone: 310-857-6251