Healthcare Provider Details

I. General information

NPI: 1215255385
Provider Name (Legal Business Name): CESAR REIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CESAR REIS MD

II. Dates (important events)

Enumeration Date: 05/13/2010
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10800 MAGNOLIA AVE
RIVERSIDE CA
92505-3043
US

IV. Provider business mailing address

10800 MAGNOLIA AVE
RIVERSIDE CA
92505-3043
US

V. Phone/Fax

Practice location:
  • Phone: 833-574-2273
  • Fax:
Mailing address:
  • Phone: 833-574-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberA152048
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA152048
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: