Healthcare Provider Details

I. General information

NPI: 1922024017
Provider Name (Legal Business Name): ERLINDA T REYES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2326 MCKEE RD STE D
SAN JOSE CA
95116-1600
US

IV. Provider business mailing address

3367 PINNACLE DR
SAN JOSE CA
95132-2435
US

V. Phone/Fax

Practice location:
  • Phone: 408-251-9090
  • Fax: 408-251-9919
Mailing address:
  • Phone: 408-926-5229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA45176
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: