Provider Demographics
NPI:1598452823
Name:RENSING, NICHOLAS ANTONY (DO)
Entity Type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:ANTONY
Last Name:RENSING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39000 BOB HOPE DRIVE
Mailing Address - Street 2:ACHS-GME OFFICE STE. 201
Mailing Address - City:RANCHO MIRAGE
Mailing Address - State:CA
Mailing Address - Zip Code:92270
Mailing Address - Country:US
Mailing Address - Phone:760-773-4504
Mailing Address - Fax:
Practice Address - Street 1:EISENHOWER HEALTH FAMILY MEDICINE RESIDENCY PROGRAM
Practice Address - Street 2:39000 BOB HOPE DRIVE, ACHS-GME OFFICE STE. 201,
Practice Address - City:RANCHO MIRAGE
Practice Address - State:CA
Practice Address - Zip Code:92270
Practice Address - Country:US
Practice Address - Phone:760-773-4504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program