MEDICARE: MICHAEL BENJAMIN REINES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	G87744	CA

General Provider Information

NPI Number	:	1508805748
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL BENJAMIN REINES M.D.

Provider Business Mailing Address
First Line	:	PO BOX 60790
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91116-6790
Country	:	US
Telephone Number	:	626-795-6596
Fax Number	:	626-795-8247

Provider Business Practice Location Address
First Line	:	180 NEWPORT CENTER DR
Second Line	:	SUITE 150
City	:	NEWPORT BEACH
State	:	CA
Zip	:	92660-6972
Country	:	US
Telephone Number	:	949-887-1580
Fax Number	:	949-612-1845

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2006
Last Update Date	:	07/14/2014

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