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RENAISSANCE ASTHETIC LASER & VEIN INSTITUTE A MEDICAL CORPORATION NPI 1730258187


NPI Information

NPI: 1730258187
Provider Name: RENAISSANCE ASTHETIC LASER & VEIN INSTITUTE, A MEDICAL CORPORATION
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
2100 LYNN RD STE 100
THOUSAND OAKS, CA
ZIP 91360
Phone: (805) 496-4242
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RENAISSANCE ASTHETIC LASER & VEIN INSTITUTE, A MEDICAL CORPORATION is a general practice in Thousand Oaks, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee RENAISSANCE ASTHETIC LASER & VEIN INSTITUTE, A MEDICAL CORPORATION NPI is 1730258187. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2100 LYNN RD STE 100
THOUSAND OAKS, CA
ZIP 91360-030
Phone: (805) 496-4242

The provider's authorized official is Kouros Azar .
The authorized official title is President and has the following contact phone number (805) 496-4242.

The enumeration date for this NPI number is 11/7/2006 and was last updated on 7/21/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208D00000XGeneral PracticeCALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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