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General NPI Number Information
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NPI Number | 1295542207
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Entity Type | Organization
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Legal Business Name | RENUANCE COSMETIC SURGERY CENTER
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 24687 MONROE AVE
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City | MURRIETA
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State | CA
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Zip | 92562-9591
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Country | US
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Telephone | 951-506-1040
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Fax | 951-506-1044
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Provider Business Mailing Address
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Address Line | 24687 MONROE AVE
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City | MURRIETA
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State | CA
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Zip | 92562-9591
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Country | US
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Telephone | 951-506-1040
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Fax | 951-506-1044
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Authorized Official
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Title or Position | DIRECTOR
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Name | ELENA SERDA
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Credential |
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Telephone | 951-506-1040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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