Healthcare Provider Details

I. General information

NPI: 1144963281
Provider Name (Legal Business Name): ALBERT REN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2022
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD
WEST HOLLYWOOD CA
90048-1804
US

IV. Provider business mailing address

700 N SAN VICENTE BLVD STE G530
WEST HOLLYWOOD CA
90069-5060
US

V. Phone/Fax

Practice location:
  • Phone: 310-423-3277
  • Fax:
Mailing address:
  • Phone: 310-423-4612
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA189381
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: