Provider Demographics
NPI:1851612246
Name:VENEGAS, RENE MARCIAL (MD)
Entity Type:Individual
Prefix:DR
First Name:RENE
Middle Name:MARCIAL
Last Name:VENEGAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 MOUNT VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93306-4018
Mailing Address - Country:US
Mailing Address - Phone:661-326-2168
Mailing Address - Fax:661-326-2167
Practice Address - Street 1:1700 MOUNT VERNON AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93306-4018
Practice Address - Country:US
Practice Address - Phone:661-326-2168
Practice Address - Fax:661-326-2167
Is Sole Proprietor?:No
Enumeration Date:2010-06-19
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMDR-5916208600000X
CAA120024207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208600000XAllopathic & Osteopathic PhysiciansSurgery