Provider Demographics
NPI:1508995234
Name:FERTILITY INSTITUTE OF CA INC
Entity Type:Organization
Organization Name:FERTILITY INSTITUTE OF CA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GLENN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ZARN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:925-945-1628
Mailing Address - Street 1:1515 YGNACIO VALLEY RD
Mailing Address - Street 2:SUITE L
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598
Mailing Address - Country:US
Mailing Address - Phone:925-945-1628
Mailing Address - Fax:925-945-3459
Practice Address - Street 1:1515 YGNACIO VALLEY RD
Practice Address - Street 2:SUITE L
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598
Practice Address - Country:US
Practice Address - Phone:925-945-1628
Practice Address - Fax:925-945-3459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACNC80077291U00000X
CACNC0076291U00000X
CACLIA0500895016291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory