Organization
LIFESPAN MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA RENNA (CEO)
(310) 453-2335
Entity
Organization
Contact information
Practice address
2811 WILSHIRE BLVD, SUITE 610, SANTA MONICA, CA 90403-4803
(310) 453-2335
Mailing address
2811 WILSHIRE BLVD, SUITE 610, SANTA MONICA, CA 90403-4803
(310) 453-2335
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
20A6324
CA
Other
Enumeration date
03/16/2010
Last updated
03/16/2010
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