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General NPI Number Information
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NPI Number | 1275722910
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Entity Type | Organization
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Legal Business Name | RENEE S NELSON MD INC
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Dates
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Enumeration Date | 10/18/2007
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Last Update Date | 04/17/2023
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Provider Practice Location Address
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Address Line | 1301 PUNCHBOWL ST
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City | HONOLULU
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State | HI
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Zip | 96813-2499
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Country | US
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Telephone | 808-691-7143
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Fax | 808-691-7496
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Provider Business Mailing Address
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Address Line | PO BOX 1009
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City | SPRING VALLEY
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State | CA
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Zip | 91979-1009
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Country | US
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Telephone | 619-508-0908
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Fax | 619-693-3242
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RENEE S NELSON
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Credential | M.D.
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Telephone | 619-995-9949
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | G78214
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | G78214
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License Number State | CA
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