Rejuvenation Surgicenter

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

FNP36955 Issued in CA

Legal business name

REJUVENATION SURGICENTER

Practice address

17525 Ventura Blvd
Suite 101
Encino, CA 91316-3843

Phone

(818) 783-5050

Fax

(818) 783-5059

NPI assigned

May 22, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Sid Kamrava, MD

Title

Medical Director

Phone

(818) 783-5058

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1740447044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17525 VENTURA BLVD",
            "address_2": "SUITE 101",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163843",
            "fax_number": "818-783-5059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17525 VENTURA BLVD",
            "address_2": "SUITE 101",
            "city": "ENCINO",
            "state": "CA",
            "postal_code": "913163843",
            "telephone_number": "818-783-5050",
            "fax_number": "818-783-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REJUVENATION SURGICENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "KAMRAVA",
        "authorized_official_first_name": "SID",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "818-783-5058",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "CA",
            "license": "FNP36955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Kiko Reimann, MA, LMFT #103750
• Richard S Reiner, M.D.
• Howard J Reinstein, M.D.
• Kiani Reis
• Irving Reitzenstein, PHARM.D.
• Rejuvenation Surgicenter
• Rekha Lund, Lac
• Reliable Medical Supply Center, Inc
• Reliance Wound Care
• Rene Ghotanian DDS PC

• Ambulatory Surgical Clinic/Center in Encino, CA
• Providers in Encino, CA by specialty
• Ambulatory Surgical Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.