Individual
DR. JIE REN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1300 N VERMONT AVE, LOS ANGELES, CA 90027-6005
(213) 413-3000
Mailing address
210 N TUSTIN AVE, SANTA ANA, CA 92705-3807
(800) 883-7243
(714) 647-1245
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A97030
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A970300
—
CA
01
—
P00744515
RR MEDICARE
CA
Enumeration date
11/10/2006
Last updated
10/22/2009
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