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General NPI Number Information
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NPI Number | 1023557444
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Entity Type | Organization
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Legal Business Name | AMERICAN FERTILITY MEDICAL CENTER CORPORATION
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Dates
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Enumeration Date | 02/17/2017
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Last Update Date | 02/17/2017
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Provider Practice Location Address
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Address Line | 2 HUGHES SUITE 175
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City | IRVINE
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State | CA
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Zip | 92618-2056
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Country | US
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Telephone | 626-476-4863
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Fax |
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Provider Business Mailing Address
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Address Line | 1306 CAMERONS AVE
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-2205
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Country | US
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Telephone | 626-476-4863
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS T LEE
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Credential | M.D.
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Telephone | 626-476-4863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC15822
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number |
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License Number State | CA
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