Renew Health Medical Corporation

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

Legal business name

RENEW HEALTH MEDICAL CORPORATION

Doing business as

Renew Health Medical Corporation

Practice address

30230 Rancho Viejo Rd Ste 134
San Juan Capistrano, CA 92675-1585

Phone

(949) 503-1414

NPI assigned

Nov 26, 2024

Organization subpart

No

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

Authorized official

Name

Tanya Dall, MDNPI 1932563533

Title

Owner

Phone

(949) 702-6736

Specialties & licenses 1

Addresses

Other names 1

• Renew Health Medical Corporation Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tanya Dall, MD

  • Emergency Medicine Physician
  • San Juan Capistrano, CA
  • NPI 1932563533
  Medicare reassignment Care Compare group NPD Authorized official
• Justin Lee Yanuck, M.D.

  • Emergency Medicine Physician
  • Downey, CA
  • NPI 1235592478
  Medicare reassignment Care Compare group NPD
• Julia Samarin

  • Psychiatric/Mental Health Nurse Practitioner
  • Tustin, CA
  • NPI 1003793738
  NPD
• Susan Ma

  • Psychiatric/Mental Health Nurse Practitioner
  • Tustin, CA
  • NPI 1154120814
  NPD (past)

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

{
    "created_epoch": "1732579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1629894324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 SPUR ST",
            "city": "RANCHO MISSION VIEJO",
            "state": "CA",
            "postal_code": "926941614",
            "telephone_number": "949-702-6736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30230 RANCHO VIEJO RD STE 134",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751585",
            "telephone_number": "949-503-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17581 Irvine Blvd Ste 114",
            "address_purpose": "LOCATION",
            "city": "Tustin",
            "state": "CA",
            "postal_code": "927803123",
            "country_code": "US",
            "telephone_number": "949-503-1414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "RENEW HEALTH MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-26",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "DALL",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-702-6736",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renew Health Medical Corporation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kendall B Raymond
• Reactive Medical Center, Inc
• Recovery Solutions LLC (Saddleback Recovery)
• Margot Reich
• Laura Ann Reilly, OTR
• Renew PC
• Resolve Chiropractic a Naasz-Sandoval Corporation
• Carlos H Restrepo, D.D.S.
• Ralf V Reuland, MD
• Nadia Rezaiamiri, D.D.S.

• Emergency Medicine Physician in San Juan Capistrano, CA
• Providers in San Juan Capistrano, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.