Healthcare Provider Details

I. General information

NPI: 1821916438
Provider Name (Legal Business Name): JOHN REITANO M.D. PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 30TH ST STE 202A
OAKLAND CA
94609-3319
US

IV. Provider business mailing address

526 S TONOPAH DR STE 160
LAS VEGAS NV
89106-4044
US

V. Phone/Fax

Practice location:
  • Phone: 702-897-7250
  • Fax:
Mailing address:
  • Phone: 702-897-7250
  • Fax: 702-706-4838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN REITANO
Title or Position: OWNER
Credential: MD
Phone: 702-897-7250