What is LIFESPAN MEDICINE's NPI number?

The NPI number assigned to this healthcare provider is 1043536592, enumerated as a organization on April 8, 2010.

Where is the provider located?

The provider is located at 2811 WILSHIRE BLVD SUITE 610 SANTA MONICA, CA 90403 and the phone number is (310) 453-2335.

What is the provider's specialty?

The provider's specialty is General Practice with taxonomy code 208D00000X.

LIFESPAN MEDICINE - NPI 1043536592 - General Practice in Santa Monica, CA

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About Lifespan Medicine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFESPAN MEDICINE (NPI 1043536592) is a healthcare organization registered as a general practice in Santa Monica, California and active in the NPI registry since April 2010. The organization lists Gina Renne, Ceo, as its authorized official.

NPPES Registry Identity

NPI1043536592

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameLIFESPAN MEDICINE

Location Address2811 WILSHIRE BLVD, SUITE 610Santa Monica, CA 90403

Mailing Address2811 Wilshire Blvd, #610Santa Monica, CA 90403 · (310) 453-2335 · Fax (310) 453-2332

Phone(310) 453-2335

Fax(310) 453-2332

Organization SubpartNo

Authorized OfficialGina RenneCeo · (310) 453-2335

Enumeration DateApril 8, 2010

✔ NPI 1043536592 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

2811 WILSHIRE BLVD, Santa Monica, CA 90403

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP