Active NPI
David Dale Renaud, M.D.
- General Practice Physician
- Santa Monica, CA
National Provider Identifier
1427221126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- A103161
- Practice address
- 1450 10TH St.
#200
Santa Monica, CA 90401 - Phone
- (310) 899-9793
- Fax
- (310) 576-7708
- NPI assigned
- Apr 2, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | A103161 | CA | Primary |
Addresses
Primary practice location
1450 10TH St.
#200
Santa Monica, CA 90401
Mailing address
20280 S Vermont Ave
Ste 120
Torrance, CA 90502-1370
Phone (310) 899-9793
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
| License | State | Type | Specialty |
|---|---|---|---|
| A103161 | CA | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 10TH Street After Hours Urgent Care | Past | Accepting new patients | |
| Family Health Associates of Santa Monica | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Urgent Care Clinic/Center
- Santa Monica, CA
- NPI 1962773861
-
- Family Medicine Physician
- Santa Monica, CA
- NPI 1174521462
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1207094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489104000000",
"number": "1427221126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20280 S VERMONT AVE",
"address_2": "STE 120",
"city": "TORRANCE",
"state": "CA",
"postal_code": "905021370",
"telephone_number": "310-899-9793",
"fax_number": "310-576-7708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1450 10TH ST.",
"address_2": "#200",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "90401",
"telephone_number": "310-899-9793",
"fax_number": "310-576-7708"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENAUD",
"first_name": "DAVID",
"middle_name": "DALE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-04-02",
"last_updated": "2017-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "A103161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.