Lifespan Medicine

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

LIFESPAN MEDICINE

Practice address

2811 Wilshire Blvd
Suite 610
Santa Monica, CA 90403

Phone

(310) 453-2335

Fax

(310) 453-2332

NPI assigned

Apr 8, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Gina Renne, CEO

Title

Ceo

Phone

(310) 453-2335

Specialties & licenses 1

Addresses

Tax ID family

Lifespan Medicine3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Lifespan Medicine

  • Adult Medicine Physician
  • Santa Monica, CA
  • NPI 1417271750
  NPD tax ID
• Lifespan Medicine

  • Point of Service
  • Santa Monica, CA
  • NPI 1669924148
  NPD tax ID

Locations

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270684800000",
    "number": "1043536592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "#610",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90403",
            "telephone_number": "310-453-2335",
            "fax_number": "310-453-2332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 WILSHIRE BLVD",
            "address_2": "SUITE 610",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "90403",
            "telephone_number": "310-453-2335",
            "fax_number": "310-453-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPAN MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-08",
        "last_updated": "2010-04-08",
        "status": "A",
        "authorized_official_last_name": "RENNE",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-453-2335",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Michael Lieb, MD
• Nir Liebenthal
• Michael Jonathan Lieber, M.D.
• Alan Liebert, LMFT107210
• Howard Liebowitz, M.D.
• Lifespan Medicine
• Lifespan Medicine
• Like Family Home Nursing Services, Inc.
• Annie Lim, RPH
• Su Lim

• General Practice Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.