1134330673 NPI number — SHER INSTITUTE FOR REPRODUCTIVE MEDICINE LOS ANGELES MEDICAL GROUP INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134330673 NPI number — SHER INSTITUTE FOR REPRODUCTIVE MEDICINE LOS ANGELES MEDICAL GROUP INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SHER INSTITUTE FOR REPRODUCTIVE MEDICINE LOS ANGELES MEDICAL GROUP INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1134330673
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5320 S. RAINBOW BLVD
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
LAS VEGAS
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89118
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-794-0073
Provider Business Mailing Address Fax Number:
702-696-0554

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1520 E CHEVY CHASE DR
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
GLENDALE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91206-4106
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-291-1985
Provider Business Practice Location Address Fax Number:
818-291-1986
Provider Enumeration Date:
05/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BAYRAK
Authorized Official First Name:
AYKUT
Authorized Official Middle Name:
Authorized Official Title or Position:
MEDICA DIRECTOR
Authorized Official Telephone Number:
818-291-1985

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  6803906 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VE0102X , with the licence number: 6803906 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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