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General NPI Number Information
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NPI Number | 1104017110
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Entity Type | Organization
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Legal Business Name | REESE E POLESKY MD INC.
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 05/21/2019
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Provider Practice Location Address
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Address Line | 703 N CAMDEN DR
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City | BEVERLY HILLS
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State | CA
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Zip | 90210-3204
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Country | US
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Telephone | 310-281-2111
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Fax | 310-281-2118
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Provider Business Mailing Address
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Address Line | 50 N LA CIENEGA BLVD SUITE 215
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-2227
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Country | US
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Telephone | 310-281-2111
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Fax | 310-281-2118
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Authorized Official
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Title or Position | PRESIDENT
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Name | REESE EUGENE POLESKY
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Credential | MD
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Telephone | 310-281-2111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | G6438
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License Number State | CA
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