Healthcare Provider Details

I. General information

NPI: 1154838175
Provider Name (Legal Business Name): LOUIS SAMUEL REIER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2017
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N PEPPER AVE
COLTON CA
92324-1819
US

IV. Provider business mailing address

400 N PEPPER AVE
COLTON CA
92324-1819
US

V. Phone/Fax

Practice location:
  • Phone: 909-580-3496
  • Fax: 909-580-3332
Mailing address:
  • Phone: 909-580-3496
  • Fax: 909-580-3332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number20A19686
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: