Individual provider Active NPI

Renu Sosamma Eapen, MBBS, FRACS

  • Urology Physician
  • San Francisco, CA
National Provider Identifier
1134673569
Registry record updated Aug 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
454 Issued in CA
Practice address
1825 4TH St FL 4
San Francisco, CA 94143-2350
Phone
(504) 729-7964
NPI assigned
Aug 15, 2016
Last updated
Aug 15, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 454 CA Primary

Addresses

Primary practice location

1825 4TH St FL 4
San Francisco, CA 94143-2350

Mailing address

1010 16TH St Apt 267
San Francisco, CA 94107-3723
Phone (504) 729-7964

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
454CAMDUrology Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471219200000",
    "number": "1134673569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1010 16TH ST APT 267",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941073723",
            "telephone_number": "504-729-7964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 4TH ST FL 4",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941432350",
            "telephone_number": "504-729-7964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAPEN",
        "first_name": "RENU",
        "middle_name": "SOSAMMA",
        "name_prefix": "Dr.",
        "credential": "MBBS, FRACS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2016-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "CA",
            "license": "454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.