Healthcare Provider Details

I. General information

NPI: 1700893294
Provider Name (Legal Business Name): STEVEN H REYNOLDS D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 03/16/2020
Certification Date: 03/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5865 E NAPLES PLZ
LONG BEACH CA
90803-5040
US

IV. Provider business mailing address

5977 E. SPRING ST.
LONG BEACH CA
90808
US

V. Phone/Fax

Practice location:
  • Phone: 562-434-4481
  • Fax: 562-434-5713
Mailing address:
  • Phone: 562-421-3727
  • Fax: 562-420-8948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A6475
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: