Active NPI
Renee Cobos, MD
- Dermatology Physician
- Brea, CA
National Provider Identifier
1801896857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- G64293
- Practice address
- 475 S State College Blvd
Brea, CA 92821-5726 - Phone
- (714) 870-7546
- Fax
- (714) 447-3376
- NPI assigned
- Jul 29, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| MOHS-Micrographic Surgery Physician | 207ND0101X | G64293 | CA | |
| Dermatopathology Physician | 207ND0900X | G64293 | CA | |
| Clinical & Laboratory Dermatological Immunology Physician | 207NI0002X | G64293 | CA | |
| Pediatric Dermatology Physician | 207NP0225X | G64293 | CA | |
| Procedural Dermatology Physician | 207NS0135X | G64293 | CA | |
| Dermatology Physician | 207N00000X | G64293 | CA | Primary |
Addresses
Primary practice location
475 S State College Blvd
Brea, CA 92821-5726
Mailing address
475 S State College Blvd
Brea, CA 92821-5726
Phone (714) 870-7546
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 |
|---|---|---|---|
| 64293 | CA | MD | Clinical Social Worker |
| G64293 | CA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122595200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1507852800000",
"number": "1801896857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 S STATE COLLEGE BLVD",
"city": "BREA",
"state": "CA",
"postal_code": "928215726",
"telephone_number": "714-870-7546",
"fax_number": "714-447-3376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "475 S STATE COLLEGE BLVD",
"city": "BREA",
"state": "CA",
"postal_code": "928215726",
"telephone_number": "714-870-7546",
"fax_number": "714-447-3376"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COBOS",
"first_name": "RENEE",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-29",
"last_updated": "2017-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "207ND0101X",
"taxonomy_group": "",
"desc": "Dermatology, MOHS-Micrographic Surgery",
"state": "CA",
"license": "G64293",
"primary": false
},
{
"code": "207ND0900X",
"taxonomy_group": "",
"desc": "Dermatology, Dermatopathology",
"state": "CA",
"license": "G64293",
"primary": false
},
{
"code": "207NI0002X",
"taxonomy_group": "",
"desc": "Dermatology, Clinical & Laboratory Dermatological Immunology",
"state": "CA",
"license": "G64293",
"primary": false
},
{
"code": "207NP0225X",
"taxonomy_group": "",
"desc": "Dermatology, Pediatric Dermatology",
"state": "CA",
"license": "G64293",
"primary": false
},
{
"code": "207NS0135X",
"taxonomy_group": "",
"desc": "Dermatology, Procedural Dermatology",
"state": "CA",
"license": "G64293",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "G64293",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brea, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.