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General NPI Number Information
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NPI Number | 1376229518
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Entity Type | Organization
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Legal Business Name | RENEW PHYSICAL THERAPY GROUP PC
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Dates
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Enumeration Date | 06/23/2023
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Last Update Date | 06/23/2023
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Provider Practice Location Address
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Address Line | 400 S BEVERLY DR STE 360
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-4405
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Country | US
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Telephone | 909-992-9820
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Fax |
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Provider Business Mailing Address
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Address Line | 8213 S VAN NESS AVE
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City | INGLEWOOD
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State | CA
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Zip | 90305-1545
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CYNTHIA GLASER
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Credential | PT, DPT, OCS
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Telephone | 909-992-9820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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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 | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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