Provider Demographics
NPI:1710520960
Name:ART FERTILITY LLC
Entity Type:Organization
Organization Name:ART FERTILITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HAMIDREZA
Authorized Official - Middle Name:JASON
Authorized Official - Last Name:SABOURI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-336-5063
Mailing Address - Street 1:PO BOX 1188
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-1188
Mailing Address - Country:US
Mailing Address - Phone:858-336-5063
Mailing Address - Fax:888-239-6337
Practice Address - Street 1:11568 SORRENTO VALLEY RD STE 12
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1313
Practice Address - Country:US
Practice Address - Phone:858-336-5063
Practice Address - Fax:888-239-6337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-21
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy