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General NPI Number Information
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NPI Number | 1942880349
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Entity Type | Organization
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Legal Business Name | JACOB REZNIK MD AND ALENA REZNIK MD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 04/09/2021
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 1401 AVOCADO AVE STE 302
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7787
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Country | US
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Telephone | 310-980-6038
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Fax | 949-335-6512
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Provider Business Mailing Address
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Address Line | 1401 AVOCADO AVE STE 302
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7787
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Country | US
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Telephone | 310-980-6038
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Fax | 949-335-6512
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Authorized Official
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Title or Position | MANAGER
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Name | ALENA REZNIK
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Credential | MD
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Telephone | 310-980-6038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0009X
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Taxonomy Name | Glaucoma Specialist (Ophthalmology) 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 | 207WX0120X
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Taxonomy Name | Cornea and External Diseases Specialist Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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