Provider Demographics
NPI:1306288287
Name:ELITE FERTILITY CENTER
Entity type:Organization
Organization Name:ELITE FERTILITY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
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:858-255-4781
Mailing Address - Street 1:4910 DIRECTORS PL
Mailing Address - Street 2:SUITE 150
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-3811
Mailing Address - Country:US
Mailing Address - Phone:858-255-4781
Mailing Address - Fax:
Practice Address - Street 1:4910 DIRECTORS PL
Practice Address - Street 2:SUITE 150
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-3811
Practice Address - Country:US
Practice Address - Phone:858-255-4781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG85448207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty