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General NPI Number Information
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NPI Number | 1457791485
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Entity Type | Organization
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Legal Business Name | ELITE FERTILITY CENTER
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Dates
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Enumeration Date | 07/05/2013
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Last Update Date | 07/12/2013
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Provider Practice Location Address
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Address Line | 13768 ROSWELL AVE SUITE 207
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City | CHINO
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State | CA
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Zip | 91710-1401
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Country | US
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Telephone | 909-591-2229
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Fax | 909-628-7822
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Provider Business Mailing Address
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Address Line | 13768 ROSWELL AVE SUITE 207
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City | CHINO
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State | CA
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Zip | 91710-1401
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Country | US
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Telephone | 909-591-2229
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Fax | 909-628-7822
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. ROSELYN MATEO DINSAY
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Credential | M.D.
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Telephone | 909-591-2229
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | G85448
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | G85448
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License Number State | CA
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