Provider Demographics
NPI:1982830899
Name:ADVANCED FERTILITY INSTITUTE INC
Entity Type:Organization
Organization Name:ADVANCED FERTILITY INSTITUTE INC
Other - Org Name:REPRODUCTIVE ENDOCRINE ASSOCIATES INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:BRODY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-265-1800
Mailing Address - Street 1:7514 GIRARD AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-5149
Mailing Address - Country:US
Mailing Address - Phone:619-265-1800
Mailing Address - Fax:
Practice Address - Street 1:9834 GENESEE AVE
Practice Address - Street 2:SUITE 416
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1223
Practice Address - Country:US
Practice Address - Phone:619-265-1800
Practice Address - Fax:858-457-5479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-05
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG47356207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G473560Medicare PIN