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General NPI Number Information
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NPI Number | 1679959019
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Entity Type | Individual
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Provider Name | STEPHEN REYNOLDS M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/08/2015
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Last Update Date | 08/08/2015
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Provider Practice Location Address
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Address Line | 505 PARNASSUS AVE RM M1184 DIVISION OF CARDIOLOGY
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-0124
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Country | US
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Telephone | 415-353-9156
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Fax |
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Provider Business Mailing Address
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Address Line | 505 PARNASSUS AVE RM M1184 DIVISION OF CARDIOLOGY
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-0124
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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 |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 137751
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License Number State | CA
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