Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | A75430 | CA |
NPI | 1033295662 |
---|---|
Provider Name | Dr. Daniel Rengstorff |
First Address | Redwood City, CA 94062-2851 |
Second Address | Redwood City, CA 94062-2851 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 30/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GR0025350 | (05) | CA |
H86097 | (02) | CA |
ZZZ12647Z | BLUE SHIED (01) | CA |