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NPI Code Detail

MEDICARE: RICHARD J REYNOLDS III MD

MEDICARE: RICHARD J REYNOLDS III MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RP1001XPulmonary Disease PhysicianC36017CA
2207R00000XInternal Medicine PhysicianC36017CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477518520
Entity Type Code : Individual
Provider Name (Legal Business Name) : RICHARD J REYNOLDS III MD
Provider Business Mailing Address
First Line : 1545 W FLORIDA AVE
Second Line :
City : HEMET
State : CA
Zip : 92543-3814
Country : US
Telephone Number : 951-791-1111
Fax Number : 888-856-3893
Provider Business Practice Location Address
First Line : 25109 JEFFERSON AVE STE 100
Second Line :
City : MURRIETA
State : CA
Zip : 92562-8117
Country : US
Telephone Number : 951-698-0440
Fax Number : 888-694-7606
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2006
Last Update Date : 05/10/2024

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