Provider Demographics
NPI:1679080923
Name:REPRODUCTIVE MEDICINE ASSOCIATES OF SOUTHERN CALIFORNIA, P.C.
Entity type:Organization
Organization Name:REPRODUCTIVE MEDICINE ASSOCIATES OF SOUTHERN CALIFORNIA, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARJORIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DIMASHKIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-618-3751
Mailing Address - Street 1:6009 JELLICO AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1228
Mailing Address - Country:US
Mailing Address - Phone:818-618-3751
Mailing Address - Fax:424-293-8842
Practice Address - Street 1:11500 W OLYMPIC BLVD STE 150
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90064-1527
Practice Address - Country:US
Practice Address - Phone:424-293-8841
Practice Address - Fax:424-293-8842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-09
Last Update Date:2018-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty