Healthcare Provider Details

I. General information

NPI: 1801207634
Provider Name (Legal Business Name): REBECCA MUTASCIO REIMERS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA CHRISTINA MUTASCIO

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7910 FROST ST
SAN DIEGO CA
92123-2771
US

IV. Provider business mailing address

3020 CHILDRENS WAY # MC5003
SAN DIEGO CA
92123-4223
US

V. Phone/Fax

Practice location:
  • Phone: 858-966-6710
  • Fax:
Mailing address:
  • Phone: 858-309-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License NumberA176526
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number274009
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA176526
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberA176526
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: