Healthcare Provider Details

I. General information

NPI: 1487236972
Provider Name (Legal Business Name): REUT RON PAGI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2021
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8500 WILSHIRE BLVD STE 917
BEVERLY HILLS CA
90211-3107
US

IV. Provider business mailing address

8500 WILSHIRE BLVD STE 917
BEVERLY HILLS CA
90211-3107
US

V. Phone/Fax

Practice location:
  • Phone: 310-789-2058
  • Fax:
Mailing address:
  • Phone: 310-789-2058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. REUT RON PAGI
Title or Position: PRESIDENT/PEDIATRICIAN
Credential: MD
Phone: 310-789-2058