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General NPI Number Information
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NPI Number | 1164853305
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Entity Type | Organization
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Legal Business Name | REPRODUCTIVE SPECIALTY SURGERICAL CENTER, INC.
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Dates
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Enumeration Date | 12/12/2013
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Last Update Date | 12/12/2013
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Provider Practice Location Address
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Address Line | 15500 SAND CANYON AVE SUITE 100
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City | IRVINE
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State | CA
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Zip | 92618-7709
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Country | US
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Telephone | 949-726-0600
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Fax | 949-726-0601
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Provider Business Mailing Address
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Address Line | 15500 SAND CANYON AVE SUITE 100
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City | IRVINE
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State | CA
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Zip | 92618-7709
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Country | US
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Telephone | 949-726-0600
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Fax | 949-726-0601
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAWRENCE B WERLIN
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Credential | M.D.
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Telephone | 949-726-0648
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0006X
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Taxonomy Name | Ambulatory Fertility Facility
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License Number | 4567
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License Number State | CA
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