Organization Active NPI

Collab Fertility Medical, Inc.

  • Reproductive Endocrinology Physician
  • Walnut Creek, CA
National Provider Identifier
1932970449
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
Legal business name
COLLAB FERTILITY MEDICAL, INC.
Practice address
2700 Ygnacio Valley Rd Ste 170
Walnut Creek, CA 94598-3460
Phone
(925) 270-2992
Fax
(925) 588-7980
NPI assigned
Jan 12, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Thalia Ruth Segal, MDNPI 1467751255
Title
Owner
Phone
(925) 270-2992

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VE0102X Primary

Addresses

Primary practice location

2700 Ygnacio Valley Rd Ste 170
Walnut Creek, CA 94598-3460

Mailing address

2700 Ygnacio Valley Rd Ste 170
Walnut Creek, CA 94598-3460
Phone (925) 270-2992

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2299656Collab Fertility2700 Ygnacio Valley Rd Ste 170, Walnut Creek, CA 94598AccreditationMay 20, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1705017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705017600000",
    "number": "1932970449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 YGNACIO VALLEY RD STE 170",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983460",
            "telephone_number": "925-270-2992",
            "fax_number": "925-588-7980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 YGNACIO VALLEY RD STE 170",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945983460",
            "telephone_number": "925-270-2992",
            "fax_number": "925-588-7980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLLAB FERTILITY MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-12",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A",
        "authorized_official_last_name": "SEGAL",
        "authorized_official_first_name": "THALIA",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "925-270-2992",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut Creek, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.