NPIMap

Organization Active NPI

Renaissance Health Services

  • Adult Medicine Physician
  • West Hollywood, CA
National Provider Identifier
1407077217
Registry record updated Apr 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
20A3999 Issued in CA
Legal business name
RENAISSANCE HEALTH SERVICES
Practice address
8733 Beverly Blvd
#408
West Hollywood, CA 90048
Phone
(310) 360-0280
Fax
(310) 360-0955
NPI assigned
May 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2009

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

Authorized official

Name
Mr. Jenny Benavides, DO
Title
Medical Assistant
Phone
(310) 360-0280

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X 20A3999 CA Primary

Addresses

Primary practice location

8733 Beverly Blvd
#408
West Hollywood, CA 90048

Mailing address

8733 Beverly Blvd
#408
West Hollywood, CA 90048
Phone (310) 360-0280

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239148800000",
    "number": "1407077217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8733 BEVERLY BLVD",
            "address_2": "#408",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "90048",
            "telephone_number": "310-360-0280",
            "fax_number": "310-360-0955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8733 BEVERLY BLVD",
            "address_2": "#408",
            "city": "WEST HOLLYWOOD",
            "state": "CA",
            "postal_code": "90048",
            "telephone_number": "310-360-0280",
            "fax_number": "310-360-0955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2009-04-08",
        "status": "A",
        "authorized_official_last_name": "BENAVIDES",
        "authorized_official_first_name": "JENNY",
        "authorized_official_title_or_position": "MEDICAL ASSISTANT",
        "authorized_official_telephone_number": "310-360-0280",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CA",
            "license": "20A3999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Hollywood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2009; 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.