1982830899 NPI number — ADVANCED FERTILITY INSTITUTE INC

Table of content: DR. TIMOTHY PAUL NAAB PT DPT (NPI 1730199084)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982830899 NPI number — ADVANCED FERTILITY INSTITUTE INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED FERTILITY INSTITUTE 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:
6
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:
1982830899
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/12/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7514 GIRARD AVE
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
LA JOLLA
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92037-5149
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
619-265-1800
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9834 GENESEE AVE
Provider Second Line Business Practice Location Address:
SUITE 416
Provider Business Practice Location Address City Name:
LA JOLLA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92037-1223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
619-265-1800
Provider Business Practice Location Address Fax Number:
858-457-5479
Provider Enumeration Date:
06/05/2009

Additional Information

Authorized Official

Authorized Official Last Name:
BRODY
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
ANDREW
Authorized Official Title or Position:
OWNER PRESIDENT
Authorized Official Telephone Number:
619-265-1800

Provider Taxonomy Codes

  • Taxonomy code: 207VE0102X , with the licence number:  G47356 , 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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