Provider Demographics
NPI:1326665621
Name:REPRODUCTIVE MEDICINE ASSOCIATES OF SAN DIEGO
Entity Type:Organization
Organization Name:REPRODUCTIVE MEDICINE ASSOCIATES OF SAN DIEGO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGED CARE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-656-2840
Mailing Address - Street 1:140 ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:BASKING RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07920-2976
Mailing Address - Country:US
Mailing Address - Phone:908-604-7800
Mailing Address - Fax:
Practice Address - Street 1:4510 EXECUTIVE DR STE 150
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2155
Practice Address - Country:US
Practice Address - Phone:908-604-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty