Healthcare Provider Details

I. General information

NPI: 1336151455
Provider Name (Legal Business Name): JAMES REID M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 11/11/2024
Certification Date: 11/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8530 WILSHIRE BLVD STE 530
BEVERLY HILLS CA
90211-3116
US

IV. Provider business mailing address

8530 WILSHIRE BLVD STE 530
BEVERLY HILLS CA
90211-3116
US

V. Phone/Fax

Practice location:
  • Phone: 310-438-6345
  • Fax: 310-691-8830
Mailing address:
  • Phone: 310-438-6345
  • Fax: 310-691-8830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA78619
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License NumberA78619
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberA78619
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: