Healthcare Provider Details

I. General information

NPI: 1073507406
Provider Name (Legal Business Name): LEROY RHEIN MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6840 SEPULVEDA BLVD
VAN NUYS CA
91405-4401
US

IV. Provider business mailing address

6840 SEPULVEDA BLVD
VAN NUYS CA
91405-4401
US

V. Phone/Fax

Practice location:
  • Phone: 818-442-9080
  • Fax: 818-442-9081
Mailing address:
  • Phone: 818-442-9080
  • Fax: 818-442-9081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: LEROY W RHEIN
Title or Position: OWNER
Credential: MD
Phone: 818-442-9080