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Organization
LOS ANGELES RENAISSANCE PROJECT
Active
Organization
LOS ANGELES RENAISSANCE PROJECT
Active
Other names
L.A.R.P
Organization subpart
No
Provider details
NPI number
Authorized official
MARCHAEL GORDON (CEO/FOUNDER)
(562) 578-9290
Entity
Organization
Contact information
Practice address
1216 W MADDOX ST, LONG BEACH, CA 90810-2241
(562) 578-9290
Mailing address
1216 W MADDOX ST, LONG BEACH, CA 90810-2241
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
NULL
208D00000X
General Practice Physician
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
NULL
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
343900000X
Non-emergency Medical Transport (VAN)
—
NULL
390200000X
Student in an Organized Health Care Education/Training Program
—
NULL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/17/2023
Last updated
05/20/2023
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