Healthcare Provider Details

I. General information

NPI: 1023588993
Provider Name (Legal Business Name): ALLAN W REESER RESPIRATORY CARE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2018
Last Update Date: 12/04/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 BRUCEVILLE RD
SACRAMENTO CA
95823-4671
US

IV. Provider business mailing address

5786 MESA VERDE CIR
ROCKLIN CA
95677-2628
US

V. Phone/Fax

Practice location:
  • Phone: 916-688-6246
  • Fax:
Mailing address:
  • Phone: 916-300-2214
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279C0205X
TaxonomyCritical Care Registered Respiratory Therapist
License Number28881
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: