Active NPI
Wolfgang Heinrich Renken, O.D.
- Optometrist
- Wasco, CA
National Provider Identifier
1447390737
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4802T
- Practice address
- 1301 7TH St
Wasco, CA 93280-1732 - Phone
- (661) 758-6320
- Fax
- (661) 758-6332
- NPI assigned
- Feb 7, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 4802T | CA | Primary |
Addresses
Primary practice location
1301 7TH St
Wasco, CA 93280-1732
Mailing address
1301 7TH St
Wasco, CA 93280-1732
Phone (661) 758-6320
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110059 | Other | CA | EYE MED VISION CARE |
| SD0048020 | Medicaid | CA | |
| 3582 | Other | CA | MEDICAL EYE SERVICES |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447390737",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 7TH ST",
"city": "WASCO",
"state": "CA",
"postal_code": "932801732",
"telephone_number": "661-758-6320",
"fax_number": "661-758-6332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 7TH ST",
"city": "WASCO",
"state": "CA",
"postal_code": "932801732",
"telephone_number": "661-758-6320",
"fax_number": "661-758-6332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENKEN",
"first_name": "WOLFGANG",
"middle_name": "HEINRICH",
"name_prefix": "Mr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "4802T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EYE MED VISION CARE",
"identifier": "110059",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SD0048020",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL EYE SERVICES",
"identifier": "3582",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wasco, 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.