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Renaissance Asc, LLC

Clinic/Center, Ambulatory Surgical in Palm Desert, CA. Organization (NPI-2).

NPI number1295072049
StatusActive
Last updated in NPPESApr 16, 2019

Details

NPI
1295072049
Entity type
Organization (NPI-2)
Legal business name
Renaissance Asc, LLC
Organization subpart
No
Enumeration date
Jan 14, 2013
Last updated
Apr 16, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QA1903X Clinic/Center, Ambulatory Surgical––Yes

Practice location

44139 Monterey Ave Ste B
Palm Desert, CA 92260-8700

Phone 760-773-4411 · Fax 760-773-2393

Mailing address

44139 Monterey Ave Ste B
Palm Desert, CA 92260-8700

Phone 760-773-4411 · Fax 760-773-2393

Authorized official

Michael Samuel
Medical Director
7607734411

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