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General NPI Number Information
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NPI Number | 1568640399
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Entity Type | Individual
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Provider Name | ROBERT BRUCE REYNOSO D.C.
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Gender | Male
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Dates
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Enumeration Date | 02/04/2008
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Last Update Date | 11/05/2019
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Provider Practice Location Address
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Address Line | 8941 ADAMS AVE
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-3330
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Country | US
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Telephone | 714-962-8818
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Fax | 714-962-8819
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Provider Business Mailing Address
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Address Line | 8941 ADAMS AVE
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-3330
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Country | US
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Telephone | 714-962-8818
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Fax | 714-962-8819
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC23961
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License Number State | CA
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