| Renova Specialty Care PC | |
|
120 S Spalding Dr Ste 300 Beverly Hills CA 90212-1837 | |
| (615) 499-3165 | |
| Not Available |
| Full Name | Renova Specialty Care PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 120 S Spalding Dr Ste 300, Beverly Hills, California |
| Authorized Official Name and Position | Thomas Jokerst (AO) |
| Authorized Official Contact | 6154993165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renova Specialty Care PC 120 S Spalding Dr Ste 300 Beverly Hills CA 90212-1837 | Renova Specialty Care PC 120 S Spalding Dr Ste 300 Beverly Hills CA 90212-1837 Ph: (615) 499-3165 |
| NPI Number | 1235027293 |
|---|---|
| Provider Enumeration Date | 06/26/2025 |
| Last Update Date | 08/28/2026 |
| Certification Date | 08/28/2026 |
| Medicare PECOS PAC ID | 9234628934 |
|---|---|
| Medicare Enrollment ID | O20251031003220 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235027293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RA0000X | Internal Medicine - Adolescent Medicine | () | Primary |
| Provider Name | Hee Jong Choi |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124189501 PECOS PAC ID: 0941102248 Enrollment ID: I20090427000410 |
| Provider Name | Oluwafunmilayo a Adekanbi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952678724 PECOS PAC ID: 7517492341 Enrollment ID: I20250827004619 |
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