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General NPI Number Information
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NPI Number | 1679828776
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Entity Type | Organization
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Legal Business Name | REEN MEDICAL GROUP INC
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 08/26/2014
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Provider Practice Location Address
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Address Line | 1525 N NORMA ST STE B
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City | RIDGECREST
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State | CA
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Zip | 93555-6536
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Country | US
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Telephone | 760-463-1613
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Fax | 760-463-1614
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Provider Business Mailing Address
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Address Line | 1525 N NORMA ST STE B
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City | RIDGECREST
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State | CA
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Zip | 93555-6536
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Country | US
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Telephone | 760-463-1613
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Fax | 760-463-1614
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Authorized Official
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Title or Position | CEO/PHYSICIAN
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Name | DR. AMIKJIT S REEN
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Credential | M.D.
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Telephone | 510-552-0967
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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