| Lifespan Medicine | |
|
2811 Wilshire Blvd Suite 610 Santa Monica CA 90403-4803 | |
| (310) 453-2335 | |
| Not Available |
| Full Name | Lifespan Medicine |
|---|---|
| Speciality | Family Medicine - Adult Medicine |
| Location | 2811 Wilshire Blvd, Santa Monica, California |
| Authorized Official Name and Position | Gina Renna (CEO) |
| Authorized Official Contact | 3104532335 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifespan Medicine 2811 Wilshire Blvd Suite 610 Santa Monica CA 90403-4803 Ph: (310) 453-2335 | Lifespan Medicine 2811 Wilshire Blvd Suite 610 Santa Monica CA 90403-4803 Ph: (310) 453-2335 |
| NPI Number | 1417271750 |
|---|---|
| Provider Enumeration Date | 03/16/2010 |
| Last Update Date | 03/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417271750 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | 20A6324 (California) | Primary |
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