Healthcare Provider Details

I. General information

NPI: 1740219104
Provider Name (Legal Business Name): CARLO MAGNO REYES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 TOWNSGATE RD STE 200
WESTLAKE VILLAGE CA
91361-5995
US

IV. Provider business mailing address

2475 TOWNSGATE RD STE 200
WESTLAKE VILLAGE CA
91361-5995
US

V. Phone/Fax

Practice location:
  • Phone: 805-253-2773
  • Fax: 877-693-1682
Mailing address:
  • Phone: 805-253-2773
  • Fax: 877-693-1682

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License NumberA70435
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberA70435
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: