Provider Demographics
NPI:1710927009
Name:DENENBERG, MICHAEL STEVEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:STEVEN
Last Name:DENENBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1625 CLAY DR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-6252
Mailing Address - Country:US
Mailing Address - Phone:650-941-3236
Mailing Address - Fax:408-649-5204
Practice Address - Street 1:1625 CLAY DR
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-6252
Practice Address - Country:US
Practice Address - Phone:650-941-3236
Practice Address - Fax:408-649-5204
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2020-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC26147207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0872750001Medicare NSC
CA00C261470Medicare PIN