Provider Demographics
NPI:1558423129
Name:BRENMAN, ROBERT D (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:BRENMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:689 TANK FARM RD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-7077
Mailing Address - Country:US
Mailing Address - Phone:805-541-1177
Mailing Address - Fax:805-541-4236
Practice Address - Street 1:689 TANK FARM RD
Practice Address - Street 2:SUITE 220
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-7077
Practice Address - Country:US
Practice Address - Phone:805-541-1177
Practice Address - Fax:805-541-4236
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG11446207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A38349Medicare UPIN