Provider Demographics
NPI:1205098589
Name:SHER INSTITUE FOR REPRODUCTIVE MEDICINE LOS ANGELES MEDICAL GROUP INC.
Entity type:Organization
Organization Name:SHER INSTITUE FOR REPRODUCTIVE MEDICINE LOS ANGELES MEDICAL GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRODY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-455-6100
Mailing Address - Street 1:5320 S RAINBOW BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89118-1840
Mailing Address - Country:US
Mailing Address - Phone:702-794-0073
Mailing Address - Fax:702-696-0554
Practice Address - Street 1:8899 UNIVERSITY CENTER LN
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-1013
Practice Address - Country:US
Practice Address - Phone:702-794-0073
Practice Address - Fax:702-696-0554
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SHER INSTITUTE SAN DIEGO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG47356207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty