Provider Demographics
NPI:1497910251
Name:PALTA, RENEE (DO)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:
Last Name:PALTA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:RENEE
Other - Middle Name:
Other - Last Name:SHANDIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:12291 WASHINGTON BLVD
Mailing Address - Street 2:SUITE #201
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-2500
Mailing Address - Country:US
Mailing Address - Phone:562-698-0306
Mailing Address - Fax:562-693-7016
Practice Address - Street 1:15141 WHITTIER BLVD
Practice Address - Street 2:SUITE #260
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2135
Practice Address - Country:US
Practice Address - Phone:562-698-0306
Practice Address - Fax:562-693-7016
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10322207RG0100X, 207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology