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General NPI Number Information
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NPI Number | 1326665621
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Entity Type | Organization
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Legal Business Name | REPRODUCTIVE MEDICINE ASSOCIATES OF SAN DIEGO
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Dates
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Enumeration Date | 07/02/2020
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Last Update Date | 07/02/2020
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Provider Practice Location Address
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Address Line | 4510 EXECUTIVE DR STE 150
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City | SAN DIEGO
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State | CA
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Zip | 92121-2155
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Country | US
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Telephone | 908-604-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 140 ALLEN RD
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City | BASKING RIDGE
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State | NJ
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Zip | 07920-2976
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Country | US
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Telephone | 908-604-7800
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Fax |
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Authorized Official
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Title or Position | MANAGED CARE COORDINATOR
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Name | REBECCA JENCO
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Credential |
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Telephone | 973-656-2840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 |
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