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General NPI Number Information
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NPI Number | 1215100433
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE HEALTH FOR ALL FERTILITY MEDICAL GROUP
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 04/09/2008
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Provider Practice Location Address
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Address Line | 5455 WILSHIRE BLVD 1904
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City | LOS ANGELES
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State | CA
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Zip | 90036-4201
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Country | US
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Telephone | 323-525-3377
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Fax | 323-525-3376
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Provider Business Mailing Address
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Address Line | 5455 WILSHIRE BLVD 1904
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City | LOS ANGELES
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State | CA
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Zip | 90036-4201
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Country | US
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Telephone | 323-525-3377
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Fax | 323-525-3376
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MRS. MARJORIE LYNN DIMASHKIE
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Credential |
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Telephone | 323-525-3377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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