Provider Demographics
NPI:1598093502
Name:IN VITROTECH LABS, INC
Entity Type:Organization
Organization Name:IN VITROTECH LABS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:ELIRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-907-1571
Mailing Address - Street 1:9301 WILSHIRE BLVD STE 313
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-6131
Mailing Address - Country:US
Mailing Address - Phone:310-550-1951
Mailing Address - Fax:310-550-1971
Practice Address - Street 1:9301 WILSHIRE BLVD STE 313
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-6131
Practice Address - Country:US
Practice Address - Phone:310-550-1951
Practice Address - Fax:310-550-1971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA85787261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical