Provider Demographics
NPI:1366869133
Name:RENEE N MAGANA MD INC
Entity type:Organization
Organization Name:RENEE N MAGANA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-415-1236
Mailing Address - Street 1:2002 4TH ST
Mailing Address - Street 2:105
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-1131
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2002 4TH ST
Practice Address - Street 2:105
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-1131
Practice Address - Country:US
Practice Address - Phone:310-415-1236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health