Provider Demographics
NPI:1861472649
Name:NIENOW, JOHN ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ROBERT
Last Name:NIENOW
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2300 CALIFORNIA ST STE 306
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-2754
Mailing Address - Country:US
Mailing Address - Phone:415-202-1550
Mailing Address - Fax:415-776-8233
Practice Address - Street 1:2300 CALIFORNIA ST STE 306
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115
Practice Address - Country:US
Practice Address - Phone:415-202-1550
Practice Address - Fax:415-776-8233
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2020-02-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA00G795490207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF43448Medicare UPIN