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General NPI Number Information
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NPI Number | 1538038989
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Entity Type | Organization
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Legal Business Name | AGAPE MEDICAL GROUP WEST PC
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 8550 SANTA MONICA BLVD FL 2
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90069-4496
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Country | US
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Telephone | 877-894-5415
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Fax |
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Provider Business Mailing Address
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Address Line | 1301 N BROADWAY # 32260
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City | LOS ANGELES
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State | CA
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Zip | 90012-1408
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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 | OPERATIONS ADMINISTRATOR
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Name | BAILEY RENGER
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Credential |
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Telephone | 877-894-5415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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