MEDICARE: RENEW SURGERY CENTERS INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1861100158
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RENEW SURGERY CENTERS INC.

Provider Business Mailing Address
First Line	:	8218 GARFIELD AVE
Second Line	:
City	:	BELL GARDENS
State	:	CA
Zip	:	90201-6212
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8218 GARFIELD AVE
Second Line	:
City	:	BELL GARDENS
State	:	CA
Zip	:	90201-6212
Country	:	US
Telephone Number	:	310-986-5469
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. ROBERT AZIZI
Credential	:	MD
Telephone Number	:	310-409-9059

Provider Enumeration Date	:	11/07/2022
Last Update Date	:	12/22/2022

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