Provider Demographics
NPI:1134330673
Name:SHER INSTITUTE FOR REPRODUCTIVE MEDICINE LOS ANGELES MEDICAL GROUP INC
Entity Type:Organization
Organization Name:SHER INSTITUTE FOR REPRODUCTIVE MEDICINE LOS ANGELES MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICA DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AYKUT
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYRAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-291-1985
Mailing Address - Street 1:5320 S. RAINBOW BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118
Mailing Address - Country:US
Mailing Address - Phone:702-794-0073
Mailing Address - Fax:702-696-0554
Practice Address - Street 1:1520 E CHEVY CHASE DR
Practice Address - Street 2:SUITE 101
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-4106
Practice Address - Country:US
Practice Address - Phone:818-291-1985
Practice Address - Fax:818-291-1986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6803906207V00000X, 207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G080390Medicare UPIN