Healthcare Provider Details

I. General information

NPI: 1871760041
Provider Name (Legal Business Name): ESKILD A REINHOLD MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26520 CACTUS AVE
MORENO VALLEY CA
92555-3927
US

IV. Provider business mailing address

PO BOX 7270
MORENO VALLEY CA
92552-7270
US

V. Phone/Fax

Practice location:
  • Phone: 951-486-5704
  • Fax: 951-486-5705
Mailing address:
  • Phone: 951-486-5704
  • Fax: 951-486-5705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberG17363
License Number StateCA

VIII. Authorized Official

Name: ESKILD ALF REINHOLD
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 951-486-5704