Healthcare Provider Details

I. General information

NPI: 1780137018
Provider Name (Legal Business Name): SPRING FERTILITY MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2016
Last Update Date: 08/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DANIEL BURNHAM CT SUITE 100C
SAN FRANCISCO CA
94109-5455
US

IV. Provider business mailing address

1 DANIEL BURNHAM CT SUITE 100C
SAN FRANCISCO CA
94109-5455
US

V. Phone/Fax

Practice location:
  • Phone: 415-202-6236
  • Fax:
Mailing address:
  • Phone: 415-202-6236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DERALD SUE
Title or Position: CFO
Credential:
Phone: 415-202-6236