# LOS ANGELES RENAISSANCE PROJECT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** L.A.R.P
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477255222
- **Authorized official:** MARCHAEL GORDON (CEO/FOUNDER)
- **Authorized official phone:** (562) 578-9290

## Contact information

- **Practice address:** 1216 W MADDOX ST, LONG BEACH, CA 90810-2241
- **Practice address phone:** (562) 578-9290
- **Mailing address:** 1216 W MADDOX ST, LONG BEACH, CA 90810-2241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 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