Healthcare Provider Details

I. General information

NPI: 1902807357
Provider Name (Legal Business Name): IVF-ORANGE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 S BATAVIA ST
ORANGE CA
92868-3936
US

IV. Provider business mailing address

431 S BATAVIA ST
ORANGE CA
92868-3937
US

V. Phone/Fax

Practice location:
  • Phone: 714-771-7800
  • Fax: 714-289-9900
Mailing address:
  • Phone: 714-771-7800
  • Fax: 714-289-9900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DARUSH LAWRENCE MOHYI
Title or Position: ADMINISTRATOR
Credential: M.D.
Phone: 714-771-7800