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General NPI Number Information
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NPI Number | 1649378894
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Entity Type | Organization
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Legal Business Name | ADVANCED INSTITUTE FOR OBSTETRICS GYNECOLOGY&INFERTILITY
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 02/19/2016
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Provider Practice Location Address
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Address Line | 18411 CLARK ST SUITE 103
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City | TARZANA
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State | CA
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Zip | 91356-3506
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Country | US
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Telephone | 818-559-3600
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Fax | 818-559-3699
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Provider Business Mailing Address
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Address Line | 18411 CLARK ST SUITE 103
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City | TARZANA
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State | CA
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Zip | 91356-3506
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Country | US
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Telephone | 818-559-3600
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Fax | 818-559-3699
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Authorized Official
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Title or Position | MD/OWNER
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Name | JEHUDA RENAN
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Credential | MD
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Telephone | 818-729-8543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | A41738
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License Number State | CA
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