Organization
RENAISSANCE ASC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL SAMUEL M.D. (MEDICAL DIRECTOR)
(760) 773-4411
Entity
Organization
Contact information
Practice address
44139 MONTEREY AVE STE B, PALM DESERT, CA 92260-8700
(760) 773-4411
(760) 773-2393
Mailing address
44139 MONTEREY AVE STE B, PALM DESERT, CA 92260-8700
(760) 773-4411
(760) 773-2393
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
01/14/2013
Last updated
04/16/2019
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