Renee Eloise Boeche, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

20A5864 Issued in CA

Practice address

301 Industrial Rd
San Carlos, CA 94070-2603

Phone

(650) 596-4100

NPI assigned

Jun 2, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1265470546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 INDUSTRIAL RD",
            "city": "SAN CARLOS",
            "state": "CA",
            "postal_code": "940702603",
            "telephone_number": "650-596-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1900 Sullivan Ave",
            "address_purpose": "LOCATION",
            "city": "Daly City",
            "state": "CA",
            "postal_code": "940152200",
            "country_code": "US",
            "telephone_number": "415-992-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOECHE",
        "first_name": "RENEE",
        "middle_name": "ELOISE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A5864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX58640",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Geoffrey Blanton
• Justine Courtney Bleeker, AMFT
• Christy Aleene Blevins, PH.D.
• Blooming Stars Therapy
• John Pierre Bloomstine
• Aidan Boese
• Nikhil Boga, DPM
• John A Boghossian, DDS
• Bryant Bernard Bolling, M.A.
• Kate Judith Bollinger, MSW

• Emergency Medicine Physician in San Carlos, CA
• Providers in San Carlos, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2020; 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.