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NPI Code Detail

MEDICARE: DR. RAYMOND M. REYES M.D.

MEDICARE: DR. RAYMOND M. REYES 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
12084P0800XPsychiatry PhysicianC050200CA

General Provider Information

NPI Number : 1821103730
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RAYMOND M. REYES M.D.
Provider Business Mailing Address
First Line : 2101 COURAGE DR
Second Line : BOX 4090, MAIL STATION 10-300
City : FAIRFIELD
State : CA
Zip : 94533-6717
Country : US
Telephone Number : 707-435-2080
Fax Number : 707-435-2103
Provider Business Practice Location Address
First Line : 2101 COURAGE DR
Second Line : BOX 4090, MAIL STATION 10-300
City : FAIRFIELD
State : CA
Zip : 94533-6717
Country : US
Telephone Number : 707-435-2080
Fax Number : 707-435-2103
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2006
Last Update Date : 07/08/2007

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