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General NPI Number Information
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NPI Number | 1689585663
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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 | 09/16/2026
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Last Update Date | 09/16/2026
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Provider Practice Location Address
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Address Line | 9720 WILSHIRE BLVD
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-2021
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Country | US
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Telephone | 310-466-0490
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Fax | 323-524-1691
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Provider Business Mailing Address
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Address Line | 1301 N BROADWAY STE 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 | 310-466-0490
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Fax | 323-524-1691
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Authorized Official
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Title or Position | ORGANIZATION ADMINISTRATOR
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Name | BAILEY RENGER
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Credential |
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Telephone | 973-943-0967
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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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