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NPI Code Detail

MEDICARE: DAVID FERNANDO RENTERIA B.A.

MEDICARE: DAVID FERNANDO RENTERIA B.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1073600565
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID FERNANDO RENTERIA B.A.
Provider Business Mailing Address
First Line : 17800 WOODRUFF AVE
Second Line :
City : BELLFLOWER
State : CA
Zip : 90706-7079
Country : US
Telephone Number : 562-977-6955
Fax Number :
Provider Business Practice Location Address
First Line : 17800 WOODRUFF AVE
Second Line :
City : BELLFLOWER
State : CA
Zip : 90706-7079
Country : US
Telephone Number : 562-977-6955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/06/2006
Last Update Date : 05/22/2013

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