Provider Demographics
NPI:1700445871
Name:RENEWED STRENGTH MEDICAL GROUP
Entity Type:Organization
Organization Name:RENEWED STRENGTH MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSE
Authorized Official - Middle Name:E
Authorized Official - Last Name:FINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-792-2430
Mailing Address - Street 1:21707 HAWTHORNE BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-7012
Mailing Address - Country:US
Mailing Address - Phone:310-792-2426
Mailing Address - Fax:310-540-9486
Practice Address - Street 1:13252 GARDEN GROVE BLVD STE 112
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-2270
Practice Address - Country:US
Practice Address - Phone:714-740-1778
Practice Address - Fax:714-740-1913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty