Individual provider Active NPI

Joel William Renbaum, M.D.

  • Specialist
  • San Francisco, CA
National Provider Identifier
1295843092
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
G17949 Issued in CA
Practice address
1 Daniel Burnham CT
Suite 365C
San Francisco, CA 94109-5455
Phone
(415) 409-7364
Fax
(415) 409-0735
NPI assigned
Aug 29, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G17949 CA Primary

Addresses

Primary practice location

1 Daniel Burnham CT
Suite 365C
San Francisco, CA 94109-5455

Mailing address

1 Daniel Burnham CT
Suite 365C
San Francisco, CA 94109-5455
Phone (415) 409-7364

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
G17949CAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
San Francisco Multispecialty Medical Group Specialist CurrentSince Jan 6, 2010 Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients
Franciscan Care Services Inc Past Accepting new patients
UCSF Health Community Hospitals Past Accepting new patients

Locations

2923 Webster St
Ste 202
Oakland, CA 94609
Phone (510) 451-4142

1 Daniel Burnham Ct
Ste 365C
San Francisco, CA 94109
Phone (415) 202-1920

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295843092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DANIEL BURNHAM CT",
            "address_2": "SUITE 365C",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941095455",
            "telephone_number": "415-409-7364",
            "fax_number": "415-409-0735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 DANIEL BURNHAM CT",
            "address_2": "SUITE 365C",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941095455",
            "telephone_number": "415-409-7364",
            "fax_number": "415-409-0735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENBAUM",
        "first_name": "JOEL",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G17949",
            "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 Jul 8, 2007; 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.