Individual provider Active NPI

Jehuda Renan, M.D.

  • Obstetrics & Gynecology Physician
  • Tarzana, CA
National Provider Identifier
1578741823
Registry record updated Dec 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A417380 Issued in CA
Practice address
18411 Clark St
Suite 103
Tarzana, CA 91356-3506
Phone
(818) 559-3600
Fax
(818) 559-3699
NPI assigned
Feb 7, 2008
Last updated
Dec 8, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X A417380 CA Primary

Addresses

Primary practice location

18411 Clark St
Suite 103
Tarzana, CA 91356-3506

Mailing address

18411 Clark St
Suite 103
Tarzana, CA 91356-3506
Phone (818) 559-3600

Other identifiers 1

IdentifierTypeStateIssuer
00A417380MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130612000478 CA Practitioner - Obstetrics/Gynecology 9931348505 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Other, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18411 Clark St
Suite 103
Tarzana, CA 91356-3527
Phone (818) 559-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A417380CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Obhg California, P.C. Obstetrics & Gynecology CurrentSince Apr 24, 2023 Accepting new patients
Advanced Institute for Obstetrics Gynecology&Infertility Obstetrics & Gynecology CurrentSince May 3, 2013 Accepting new patients
Providence Health System - Southern California Past Accepting new patients
Cedars-Sinai Medical Center Past Accepting new patients

Locations

18411 Clark St
Ste 103
Tarzana, CA 91356
Phone (818) 559-3600

215 W Janss Rd
Thousand Oaks, CA 91360
Phone (805) 379-5435

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1578741823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18411 CLARK ST",
            "address_2": "SUITE 103",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563506",
            "telephone_number": "818-559-3600",
            "fax_number": "818-559-3699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18411 CLARK ST",
            "address_2": "SUITE 103",
            "city": "TARZANA",
            "state": "CA",
            "postal_code": "913563506",
            "telephone_number": "818-559-3600",
            "fax_number": "818-559-3699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENAN",
        "first_name": "JEHUDA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-07",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A417380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A417380",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarzana, CA

Sources for this page

Verify at the official NPI Registry.