Provider Demographics
NPI:1285204834
Name:WEST COAST FERTILITY CENTERS LLC
Entity Type:Organization
Organization Name:WEST COAST FERTILITY CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VITALY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KUSHNIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:801-580-1022
Mailing Address - Street 1:11160 WARNER AVE STE 411
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-4056
Mailing Address - Country:US
Mailing Address - Phone:714-513-1399
Mailing Address - Fax:714-513-1393
Practice Address - Street 1:11160 WARNER AVE STE 411
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4056
Practice Address - Country:US
Practice Address - Phone:714-513-1399
Practice Address - Fax:714-513-1393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-27
Last Update Date:2021-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Multi-Specialty