Los Angeles Renaissance Project

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

LOS ANGELES RENAISSANCE PROJECT

Practice address

1216 W Maddox St
Long Beach, CA 90810-2241

Phone

(562) 578-9290

NPI assigned

Mar 17, 2023

Organization subpart

No

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

Authorized official

Name

Marchael Gordon

Title

Ceo/Founder

Phone

(562) 578-9290

Specialties & licenses 5

Addresses

Other names 1

• L.A.R.P Other name

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684540800000",
    "number": "1477255222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1216 W MADDOX ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908102241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 W MADDOX ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908102241",
            "telephone_number": "562-578-9290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOS ANGELES RENAISSANCE PROJECT",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-05-20",
        "certification_date": "2023-05-20",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "MARCHAEL",
        "authorized_official_title_or_position": "CEO/FOUNDER",
        "authorized_official_telephone_number": "562-578-9290"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "L.A.R.P",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "L.A.R.P",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Denise Renee Lott, L.AC.

• General Practice Physician in Long Beach, CA
• Providers in Long Beach, 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 May 20, 2023; 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.