Healthcare Provider Details

I. General information

NPI: 1922074731
Provider Name (Legal Business Name): ALICE CAROL REIER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 05/25/2023
Certification Date: 05/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 WEBSTER ST STE 900
OAKLAND CA
94609-3156
US

IV. Provider business mailing address

PO BOX 996
HAYDEN ID
83835-0996
US

V. Phone/Fax

Practice location:
  • Phone: 510-834-3700
  • Fax: 510-834-5015
Mailing address:
  • Phone: 208-664-4026
  • Fax: 855-532-5921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberG81697
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number01090098A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: