Provider Demographics
NPI:1538103742
Name:LE RENARD, CHRISTOPHE CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHE
Middle Name:CHARLES
Last Name:LE RENARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3006 S. MARYLAND PARKWAY
Mailing Address - Street 2:505
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89109
Mailing Address - Country:US
Mailing Address - Phone:888-350-2911
Mailing Address - Fax:702-369-5827
Practice Address - Street 1:1010 MURRAY ST
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-8800
Practice Address - Country:US
Practice Address - Phone:702-697-0082
Practice Address - Fax:702-369-8300
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63590208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics