Healthcare Provider Details

I. General information

NPI: 1427602911
Provider Name (Legal Business Name): REENA RAY GARG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2019
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3628 E IMPERIAL HWY STE 301
LYNWOOD CA
90262-2646
US

IV. Provider business mailing address

2629 W 235TH ST APT A
TORRANCE CA
90505-4246
US

V. Phone/Fax

Practice location:
  • Phone: 323-541-1411
  • Fax: 323-541-1499
Mailing address:
  • Phone: 518-577-0270
  • Fax: 323-541-1661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA176249
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: