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Organization
RENEW HEALTH MEDICAL CORPORATION
Active
Organization
RENEW HEALTH MEDICAL CORPORATION
Active
Other names
Renew Health Medical Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
TANYA DALL MD (OWNER)
(949) 702-6736
Entity
Organization
Contact information
Practice address
30230 RANCHO VIEJO RD STE 134, SAN JUAN CAPISTRANO, CA 92675-1585
(949) 503-1414
Mailing address
146 SPUR ST, RANCHO MISSION VIEJO, CA 92694-1614
(949) 702-6736
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
11/26/2024
Last updated
11/26/2024
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