Healthcare Provider Details
I. General information
NPI: 1235173394
Provider Name (Legal Business Name): RENEE BINDER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/16/2006
Last Update Date: 07/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
401 PARNASSUS AVE
SAN FRANCISCO CA
94143-2211
US
IV. Provider business mailing address
1635 DIVISADERO STREET SUITE 625, BOX 1821
SAN FRANCISCO CA
94143-0001
US
V. Phone/Fax
- Phone: 415-476-7304
- Fax: 415-502-2206
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084F0202X |
| Taxonomy | Forensic Psychiatry Physician |
| License Number | G27505 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | G27505 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: