Healthcare Provider Details

I. General information

NPI: 1053551994
Provider Name (Legal Business Name): CLAUDIA REAY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2009
Last Update Date: 03/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2577 SAMARITAN DR SUITE830
SAN JOSE CA
95124-4100
US

IV. Provider business mailing address

656 CRAGMONT AVE
BERKELEY CA
94708-1343
US

V. Phone/Fax

Practice location:
  • Phone: 408-356-1319
  • Fax:
Mailing address:
  • Phone: 510-526-3394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG54129
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: