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Organization
LIFESPAN MEDICINE
Active
Organization
LIFESPAN MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GINA RENNE CEO (CEO)
(310) 453-2335
Entity
Organization
Contact information
Practice address
2811 WILSHIRE BLVD, SUITE 610, SANTA MONICA, CA 90403
(310) 453-2335
(310) 453-2332
Mailing address
2811 WILSHIRE BLVD, #610, SANTA MONICA, CA 90403
(310) 453-2335
(310) 453-2332
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
04/08/2010
Last updated
04/08/2010
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