Mark Lee Renneker, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G45873 Issued in CA

Practice address

375 Laguna Honda Blvd
Laguna Honda Hospital and Rehab Ctr, Medical SVCS
San Francisco, CA 94116-1411

Phone

(415) 759-2300

Fax

(415) 759-2374

NPI assigned

Feb 7, 2007

Sex

Male

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 22, 2016 through Sep 22, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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": "1659411999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 LAGUNA HONDA BLVD",
            "address_2": "LAGUNA HONDA HOSPITAL AND REHAB CTR, MEDICAL SVCS",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941161411",
            "telephone_number": "415-759-2300",
            "fax_number": "415-759-2374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 LAGUNA HONDA BLVD",
            "address_2": "LAGUNA HONDA HOSPITAL AND REHAB CTR, MEDICAL SVCS",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941161411",
            "telephone_number": "415-759-2300",
            "fax_number": "415-759-2374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENNEKER",
        "first_name": "MARK",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G45873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G458730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Renee Spencer, MFT
• Taylor Renfroe, RD, LD
• Johanna Rengifo Nevarez, PH.D.
• Beverly Gayle Renick, FNP PA-C
• Owen D. Renik, M.D.
• Carolyn Rennels
• Ryan Nguyen Rennels
• Kathryn Elaine Rennie, M.S.
• Stephanie Rennke, MD
• Taylor Reno, DACM, L.AC

• Family Medicine Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Family Medicine Physician in California

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.