Individual
RENZO MOGOLLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
72 E CONCORD ST # 2700, BOSTON, MA 02118-2642
(617) 638-6178
Mailing address
745 W MOANA LN STE 300, RENO, NV 89509-4980
(775) 327-5174
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
3017846
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2022
Last updated
07/04/2025
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