MEDICARE: REINA SY

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	46995	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5616858	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1972584118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REINA SY

Provider Business Mailing Address
First Line	:	4526 EAGLE ROCK BLVD
Second Line	:	STE 4
City	:	LOS ANGELES
State	:	CA
Zip	:	90041-3285
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7220 ROSEMEAD BLVD
Second Line	:	STE 202-7
City	:	SAN GABRIEL
State	:	CA
Zip	:	91775-1377
Country	:	US
Telephone Number	:	323-344-1815
Fax Number	:

Authorized Official
Title or Position	:	PHARMACIST
Name	:	REINA SY
Credential	:
Telephone Number	:	323-459-2264

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	08/01/2012

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Directions to “REINA SY ” Practice Location

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