Provider Demographics
NPI:1205919008
Name:RENA, DIOKSON
Entity type:Individual
Prefix:DR
First Name:DIOKSON
Middle Name:
Last Name:RENA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 SUTTER ST STE 320
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1120
Mailing Address - Country:US
Mailing Address - Phone:415-757-0814
Mailing Address - Fax:415-757-0820
Practice Address - Street 1:500 SUTTER ST STE 320
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1120
Practice Address - Country:US
Practice Address - Phone:415-757-0814
Practice Address - Fax:415-757-0820
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC51983208100000X, 2081P2900X, 208VP0014X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine