Physician Compare National (NPI:1275642910)

HEALTHCARE PROVIDER: ELISABETH HARRIET RENNER M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1275642910
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3173627288
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20081120000917
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RENNER
	Individual professional last name
Provider First Name	ELISABETH
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	JOHN MUIR PHYSICIAN NETWORK
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	6608789813
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	395
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	5161 CLAYTON RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE F
	Group Practice or individual's line 2 address
City	CONCORD
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	945213157
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9256098282
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050180
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	JOHN MUIR MEDICAL CENTER - WALNUT CREEK CAMPUS
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050496
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	JOHN MUIR MEDICAL CENTER - CONCORD CAMPUS
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y