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General NPI Number Information
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NPI Number | 1245267400
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Entity Type | Organization
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Legal Business Name | NORMAN H. REEVES,DPM PODIATRY CORP
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Dates
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Enumeration Date | 06/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1530 S IMPERIAL AVE
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City | EL CENTRO
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State | CA
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Zip | 92243-4241
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Country | US
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Telephone | 760-337-9113
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Fax | 760-337-9108
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Provider Business Mailing Address
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Address Line | 1530 S IMPERIAL AVE P.O. BOX 4056
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City | EL CENTRO
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State | CA
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Zip | 92243-4241
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Country | US
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Telephone | 760-337-9113
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Fax | 760-337-9108
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MARY S REEVES
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Credential |
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Telephone | 760-337-9113
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | E1848
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License Number State | CA
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