Provider Demographics
NPI:1508091182
Name:CENTER FOR FERTILITY & GYNECOLOGY, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:CENTER FOR FERTILITY & GYNECOLOGY, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:VERMESH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-881-9800
Mailing Address - Street 1:18370 BURBANK BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-2804
Mailing Address - Country:US
Mailing Address - Phone:818-881-9800
Mailing Address - Fax:818-881-1857
Practice Address - Street 1:18370 BURBANK BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-2804
Practice Address - Country:US
Practice Address - Phone:818-881-9800
Practice Address - Fax:818-881-1857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty