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Individual
MR. WOLFGANG HEINRICH RENKEN
Active
Individual
MR. WOLFGANG HEINRICH RENKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4802T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110059
EYE MED VISION CARE
CA
01
—
3582
MEDICAL EYE SERVICES
CA
05
—
SD0048020
—
CA
Enumeration date
02/07/2007
Last updated
07/08/2007
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