Provider Demographics
NPI:1356361190
Name:TRENNER, DENNIS L (DPM)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:L
Last Name:TRENNER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2760 ORO DAM BLVD E
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966-5117
Mailing Address - Country:US
Mailing Address - Phone:530-534-0601
Mailing Address - Fax:530-534-0116
Practice Address - Street 1:2760 ORO DAM BLVD E
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-5117
Practice Address - Country:US
Practice Address - Phone:530-534-0601
Practice Address - Fax:530-534-0116
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2012-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3685213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E36850Medicaid
CAU19109Medicare UPIN
CA000E36850Medicare ID - Type Unspecified
CA000E36850Medicaid