Renew Life Center

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

AG51233 Issued in CA

Legal business name

RENEW LIFE CENTER

Practice address

211 De Anza Blvd
San Mateo, CA 94402-3989

Phone

(650) 350-1700

Fax

(650) 341-3604

NPI assigned

Jun 24, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Julieta Marimla Gabiola, MD

Title

President

Phone

(650) 350-1700

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1609004084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 DE ANZA BLVD",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023989",
            "telephone_number": "650-350-1700",
            "fax_number": "650-341-3604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 DE ANZA BLVD",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944023989",
            "telephone_number": "650-350-1700",
            "fax_number": "650-341-3604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW LIFE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-24",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "GABIOLA",
        "authorized_official_first_name": "JULIETA",
        "authorized_official_middle_name": "MARIMLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "650-350-1700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "AG51233",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENCE",
            "identifier": "G51233",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Remedy Medical Group
• Kelly Ren, DDS
• Cybele Anne Renault
• Katia Maricela Renderos, PHN, MSN
• Celeste Concepcion Rendon
• Daniel Rengstorff, M.D.
• Emily Renteria
• Melanie Requena
• Rescare California, Inc.
• Resolutioncare, PC

• Clinic/Center in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.