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General NPI Number Information
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NPI Number | 1720617707
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Entity Type | Organization
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Legal Business Name | MATE FERTILITY INC
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Dates
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Enumeration Date | 04/02/2020
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Last Update Date | 05/08/2020
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Provider Practice Location Address
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Address Line | 16030 VENTURA BLVD STE 404
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City | ENCINO
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State | CA
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Zip | 91436-2754
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Country | US
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Telephone | 818-728-4600
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Fax | 818-728-4616
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Provider Business Mailing Address
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Address Line | 269 S BEVERLY DR STE 8
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-3851
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Country | US
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Telephone | 310-569-0767
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. OLIVER BOGNER
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Credential |
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Telephone | 310-569-0767
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QB0400X
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Taxonomy Name | Birthing Clinic/Center
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License Number |
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License Number State |
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