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NPI Code Detail

MEDICARE: REYZELMAN NEVADA PLLC

MEDICARE: REYZELMAN NEVADA PLLC
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
1332B00000XDurable Medical Equipment & Medical Supplies
2213ES0131XFoot Surgery Podiatrist
3207ZP0101XAnatomic Pathology Physician
4207ZD0900XDermatopathology (Pathology) Physician
5213EP1101XPrimary Podiatric Medicine Podiatrist
6213ES0103XFoot & Ankle Surgery Podiatrist
7213E00000XPodiatrist

General Provider Information

NPI Number : 1497378517
Entity Type Code : Organization
Provider Name (Legal Business Name) : REYZELMAN NEVADA PLLC
Provider Business Mailing Address
First Line : PO BOX 845038
Second Line :
City : LOS ANGELES
State : CA
Zip : 90084-5038
Country : US
Telephone Number : 847-627-4920
Fax Number : 628-345-0812
Provider Business Practice Location Address
First Line : 2649 W HORIZON RIDGE PKWY STE 100
Second Line :
City : HENDERSON
State : NV
Zip : 89052-4801
Country : US
Telephone Number : 702-565-6641
Fax Number : 702-565-9249
Authorized Official
Title or Position : CMO
Name : ALEXANDER REYZELMAN
Credential : DPM
Telephone Number : 415-292-0638
Provider Enumeration Date : 05/22/2020
Last Update Date : 01/13/2026

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Directions to “REYZELMAN NEVADA PLLC ” Practice Location

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