DR. RENE HENRY BRAVO (NPI# 1255373965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255373965 |
| Entity Type | Individual |
| Full Name | DR. RENE HENRY BRAVO |
| Credential | MD |
| Practice Address |
620 California Blvd Suite J San Luis Obispo CA 93401-2541 |
| Practice Telephone | 8055444460 |
| Mailing Telephone | 8055444460 |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | G52562 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MED LICENSE | G52562 | 01 |
| Street Address |
620 CALIFORNIA BLVD SUITE J |
| City | SAN LUIS OBISPO |
| State | CA |
| Zip Code | 93401-2541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790127173 | Newsom Forester Dental Partnership | Dentist | 620 California Blvd, Suite G, San Luis Obispo, CA 93401-2541 | 2013-07-25 |
| 1437408119 | First Choice Physician Partners | Psychiatry & Neurology | 620 California Blvd, Ste J, San Luis Obispo, CA 93401-2541 | 2012-09-10 |
| 1164622908 | Elijah Uzoma Wogu | Neurological Surgery | 620 California Blvd, J, San Luis Obispo, CA 93401-2541 | 2007-07-19 |
| 1770789513 | Shervin Gholian | Dentist | 620 California Blvd, Suite G, San Luis Obispo, CA 93401-2541 | 2007-06-26 |
| 1922146497 | Kenneth Howard Germanow | Psychologist | 620 California Blvd, Suite P, San Luis Obispo, CA 93401-2541 | 2007-02-04 |
| 1003967423 | Ernest Burton Miller | Orthopaedic Surgery | 620 California Blvd, Suite Q, San Luis Obispo, CA 93401-2541 | 2007-01-13 |
| 1013075159 | James A Forester | Dentist | 620 California Blvd, Suite G, San Luis Obispo, CA 93401-2541 | 2006-12-04 |
| 1013092618 | Rachel Eulenberg Williams | Dentist | 620 California Blvd, Suite G, San Luis Obispo, CA 93401 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497228399 | Barbara Jean Morrow | Dental Hygienist | 2191 Johnson Avenue, San Luis Obispo, CA 93401 | 2019-01-03 |
| 1104307743 | Griffith Jennings | Counselor | 1225 Kendal Rd, San Luis Obispo, CA 93401 | 2018-08-22 |
| 1124518808 | Joy L Delaluna | Licensed Psychiatric Technician | 692 Evens Rd, San Luis Obispo, CA 93401 | 2018-05-17 |
| 1982192084 | Sierra Mental Wellness Group | Community/Behavioral Health | 2180 B Johnson Avenue, San Luis Obispo, CA 93401 | 2018-04-25 |
| 1326554403 | Veronica Chanel Laguna | Case Manager/Care Coordinator | 1065 Kansas Ave., San Luis Obispo, CA 93401 | 2017-12-27 |
| 1043739782 | Janette Lynn Branca | Case Manager/Care Coordinator | 285 South Street, Suit J, San Louis Obispo, CA 93401 | 2017-09-13 |
| 1588194104 | Adv Vision LLC | Optometrist | 835 Aero Vista Pl, #110, San Luis Obispo, CA 93401 | 2017-06-15 |
| 1508395880 | Samantha Clay | Counselor | 1255 Kendall Road, San Luis Obispo, CA 93401 | 2017-06-08 |
| 1659804771 | Sara Anne Powers | Counselor | 697 Higuera Street D, San Luis Obispo, CA 93401 | 2017-04-05 |
| 1508306010 | Russell Piazza | Pharmacist | 873 Ricardo Court, San Luis Obispo, CA 93401 | 2017-03-02 |
| Find all providers in zip 93401 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093057499 | Grace Xiao'en Lim | Pediatrics | 1235 Osos St Ste 100, San Luis Obispo, CA 93401 | 2013-03-23 |
| 1730421413 | Louis Tedone | Pediatrics | 206 Albert Dr, San Luis Obispo, CA 93405-1925 | 2013-03-20 |
| 1558673632 | Kara Danielle November Bryden | Pediatrics | 1235 Osos St Suite 100, San Luis Obispo, CA 93401 | 2010-07-06 |
| 1851428981 | Nisha Abdul Cader | Pediatrics | 2925 Mcmillan Ave, #103, San Luis Obispo, CA 93401-6765 | 2007-02-27 |
| 1720127319 | Monique Araya | Pediatrics | 620 California Blvd Ste J, San Luis Obispo, CA 93401-2598 | 2007-02-06 |
| 1578637179 | Sasha L. Szytel | Pediatrics | 3241 S Higuera St, San Luis Obispo, CA 93401-6924 | 2006-11-17 |
| 1295827343 | Janet E Flaton | Pediatrics | 1428 Phillips Lane, Suite B1, San Luis Obispo, CA 93401 | 2006-09-28 |
| 1235122292 | Natasha Raja | Pediatrics | 1010 Murray St, San Luis Obispo, CA 93405-8800 | 2005-08-25 |
| 1891790630 | Susan H Hoffman | Pediatrics | 79 Benton Way, San Luis Obispo, CA 93405-1717 | 2005-06-17 |
| 1992290498 | Rene H. Bravo Md Inc | Pediatrics | 3241 S Higuera St, San Luis Obispo, CA 93401-6924 | 2018-06-27 |
| Find all providers in SAN LUIS OBISPO | ||||
| City | SAN LUIS OBISPO |
| Zip Code | 93401 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.