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General NPI Number Information
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NPI Number | 1316162399
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Entity Type | Organization
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Legal Business Name | FERTILITY CENTER OF SOUTHERN CALIFORNIA
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 10/04/2022
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Provider Practice Location Address
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Address Line | 4980 BARRANCA PARKWAY, SUITE 200
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City | IRVINE
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State | CA
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Zip | 92604
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Country | US
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Telephone | 949-955-0072
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Fax | 949-955-0077
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Provider Business Mailing Address
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Address Line | 4980 BARRANCA PARKWAY, SUITE 200
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City | IRVINE
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State | CA
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Zip | 92604
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Country | US
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Telephone | 949-955-0072
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Fax | 949-955-0077
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Authorized Official
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Title or Position | PRESIDENT
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Name | LLENE E HATCH
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Credential | M.D.
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Telephone | 949-955-0072
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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 | G071146
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License Number State | CA
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