Healthcare Provider Details

I. General information

NPI: 1891540175
Provider Name (Legal Business Name): KARLA SAENZ REYES DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2024
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5454 EL CAJON BLVD
SAN DIEGO CA
92115-3621
US

IV. Provider business mailing address

5454 EL CAJON BLVD
SAN DIEGO CA
92115-3621
US

V. Phone/Fax

Practice location:
  • Phone: 619-515-2400
  • Fax:
Mailing address:
  • Phone: 619-515-2400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A24553
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: