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General NPI Number Information
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NPI Number | 1679103436
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Entity Type | Organization
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Legal Business Name | RENA AHUJA MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 01/21/2020
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Last Update Date | 01/21/2020
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Provider Practice Location Address
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Address Line | 355 PLACENTIA AVE STE 209
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3302
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Country | US
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Telephone | 949-209-2789
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Fax | 888-726-1822
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Provider Business Mailing Address
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Address Line | PO BOX 2724
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City | NEWPORT BEACH
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State | CA
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Zip | 92659-0210
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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 | OWNER / PHYSICIAN
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Name | RENA AHUJA
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Credential | MD
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Telephone | 949-209-2789
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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