Provider Demographics
NPI:1457791485
Name:ELITE FERTILITY CENTER
Entity Type:Organization
Organization Name:ELITE FERTILITY CENTER
Other - Org Name:ELITE REPRODUCTIVE HEALTH CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSELYN
Authorized Official - Middle Name:MATEO
Authorized Official - Last Name:DINSAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:909-591-2229
Mailing Address - Street 1:13768 ROSWELL AVE
Mailing Address - Street 2:SUITE 207
Mailing Address - City:CHINO
Mailing Address - State:CA
Mailing Address - Zip Code:91710-1401
Mailing Address - Country:US
Mailing Address - Phone:909-591-2229
Mailing Address - Fax:909-628-7822
Practice Address - Street 1:13768 ROSWELL AVE
Practice Address - Street 2:SUITE 207
Practice Address - City:CHINO
Practice Address - State:CA
Practice Address - Zip Code:91710-1401
Practice Address - Country:US
Practice Address - Phone:909-591-2229
Practice Address - Fax:909-628-7822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-05
Last Update Date:2013-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG85448207VE0102X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty