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General NPI Number Information
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NPI Number | 1508995234
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Entity Type | Organization
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Legal Business Name | FERTILITY INSTITUTE OF CA INC
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1515 YGNACIO VALLEY RD SUITE L
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City | WALNUT CREEK
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State | CA
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Zip | 94598
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Country | US
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Telephone | 925-945-1628
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Fax | 925-945-3459
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Provider Business Mailing Address
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Address Line | 1515 YGNACIO VALLEY RD SUITE L
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City | WALNUT CREEK
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State | CA
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Zip | 94598
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Country | US
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Telephone | 925-945-1628
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Fax | 925-945-3459
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GLENN ALLEN ZARN
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Credential | PHD
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Telephone | 925-945-1628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | CNC80077
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | CLIA0500895016
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | CNC0076
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License Number State | CA
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