Healthcare Provider Details

I. General information

NPI: 1407244767
Provider Name (Legal Business Name): PACIFIC FERTILITY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2015
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10921 WILSHIRE BLVD STE 700
LOS ANGELES CA
90024-4003
US

IV. Provider business mailing address

10921 WILSHIRE BLVD STE 700
LOS ANGELES CA
90024-4003
US

V. Phone/Fax

Practice location:
  • Phone: 310-209-7700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0006X
TaxonomyAmbulatory Fertility Facility
License Number
License Number State

VIII. Authorized Official

Name: MARY OUNDJIAN
Title or Position: CEO
Credential:
Phone: 818-504-7265