Provider Demographics
NPI:1265599088
Name:LA JOLLA IVF,INC
Entity type:Organization
Organization Name:LA JOLLA IVF,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND MEDICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:SMOTRICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-558-2221
Mailing Address - Street 1:9850 GENESEE AVE, SUITE 610
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1224
Mailing Address - Country:US
Mailing Address - Phone:858-558-2221
Mailing Address - Fax:858-558-2260
Practice Address - Street 1:9850 GENESEE AVE, SUITE 610
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1224
Practice Address - Country:US
Practice Address - Phone:858-558-2221
Practice Address - Fax:858-558-2263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2023-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA0006XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Fertility Facility
No207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA330746395OtherTAX ID