Provider Demographics
NPI:1912289133
Name:OVAGENE ONCOLOGY, INC.
Entity Type:Organization
Organization Name:OVAGENE ONCOLOGY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:KIESNER
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:949-271-8810
Mailing Address - Street 1:10 PASTEUR
Mailing Address - Street 2:SUITE 150
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-3824
Mailing Address - Country:US
Mailing Address - Phone:949-748-6415
Mailing Address - Fax:949-861-7195
Practice Address - Street 1:10 PASTEUR
Practice Address - Street 2:SUITE 150
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3824
Practice Address - Country:US
Practice Address - Phone:949-748-6415
Practice Address - Fax:949-861-7195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACLF00341215291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory