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General NPI Number Information
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NPI Number | 1043457344
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Entity Type | Organization
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Legal Business Name | DR ROBERT M REY
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Dates
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Enumeration Date | 01/08/2009
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Last Update Date | 01/08/2009
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Provider Practice Location Address
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Address Line | 436 N BEDFORD DR SUITE 304
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4310
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Country | US
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Telephone | 310-205-3107
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Fax |
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Provider Business Mailing Address
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Address Line | 436 N BEDFORD DR SUITE 304
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-4310
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT CERTIFIED
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Name | KRISTY EUMONT
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Credential | PA-C
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Telephone | 310-205-3107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA17337
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License Number State | CA
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