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NPI Code Detail

MEDICARE: PEACE LILY FERTILITY

MEDICARE: PEACE LILY FERTILITY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207VE0102XReproductive Endocrinology Physician

General Provider Information

NPI Number : 1891425955
Entity Type Code : Organization
Provider Name (Legal Business Name) : PEACE LILY FERTILITY
Provider Business Mailing Address
First Line : 160 E TASMAN DR
Second Line :
City : SAN JOSE
State : CA
Zip : 95134-1619
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1801 PEACHTREE ST NE STE 145
Second Line :
City : ATLANTA
State : GA
Zip : 30309-1895
Country : US
Telephone Number : 773-283-1795
Fax Number :
Authorized Official
Title or Position : PHYSICIAN
Name : KARENNE N FRU
Credential : MD
Telephone Number : 773-283-1795
Provider Enumeration Date : 06/13/2022
Last Update Date : 06/13/2022

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Directions to “PEACE LILY FERTILITY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.