Organization Active NPI

Renu Health Inc

  • Family Medicine Physician
  • Long Beach, CA
National Provider Identifier
1861261992
Registry record updated Feb 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
RENU HEALTH INC
Practice address
1703 Termino Ave Ste 209
Long Beach, CA 90804-2128
Phone
(562) 498-3002
NPI assigned
Dec 29, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2024

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

Authorized official

Name
Alexa Gozali, DONPI 1407309594
Title
President
Phone
(949) 293-9360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1703 Termino Ave Ste 209
Long Beach, CA 90804-2128

Mailing address

28743 Jardineras Dr
Valencia, CA 91354-3097

Other names 1

  • Renu Health Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240705001498 CA Part B Supplier - Clinic/Group Practice 4183168867 Receives reassigned benefits from 3 practitioners
Practice locations: Long Beach, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1703808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1861261992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28743 JARDINERAS DR",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913543097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 TERMINO AVE STE 209",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908042128",
            "telephone_number": "562-498-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENU HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-29",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A",
        "authorized_official_last_name": "GOZALI",
        "authorized_official_first_name": "ALEXA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-293-9360",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Renu Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.