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General NPI Number Information
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NPI Number | 1447390737
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Entity Type | Individual
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Provider Name | WOLFGANG HEINRICH RENKEN O.D.
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Gender | Male
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1301 7TH ST
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City | WASCO
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State | CA
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Zip | 93280-1732
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Country | US
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Telephone | 661-758-6320
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Fax | 661-758-6332
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Provider Business Mailing Address
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Address Line | 1301 7TH ST
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City | WASCO
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State | CA
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Zip | 93280-1732
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Country | US
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Telephone | 661-758-6320
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Fax | 661-758-6332
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4802T
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License Number State | CA
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