Provider Demographics
NPI:1801504816
Name:CLINICA DE FERTILIDAD RAS SC
Entity type:Organization
Organization Name:CLINICA DE FERTILIDAD RAS SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALOMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-260-9314
Mailing Address - Street 1:12918 CAMINITO BESO
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-3406
Mailing Address - Country:US
Mailing Address - Phone:858-260-9314
Mailing Address - Fax:
Practice Address - Street 1:AV. PASEO DEL CENTENARIO 9580
Practice Address - Street 2:SUITE 2801
Practice Address - City:TIJUANA
Practice Address - State:BAJA CALIFORNIA
Practice Address - Zip Code:22010
Practice Address - Country:MX
Practice Address - Phone:858-260-9314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0006XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Fertility Facility