MEDICARE: DR. JAMES FRANCIS REILLY M.D.

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
1	207Q00000X	Family Medicine Physician	G51287	CA
2	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	G51287	CA

General Provider Information

NPI Number	:	1891776258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES FRANCIS REILLY M.D.

Provider Business Mailing Address
First Line	:	1808 VERDUGO BLVD
Second Line	:	209
City	:	GLENDALE
State	:	CA
Zip	:	91208-1477
Country	:	US
Telephone Number	:	818-949-4494
Fax Number	:	818-949-7330

Provider Business Practice Location Address
First Line	:	1808 VERDUGO BLVD
Second Line	:	209
City	:	GLENDALE
State	:	CA
Zip	:	91208-1477
Country	:	US
Telephone Number	:	818-949-4494
Fax Number	:	818-949-7330

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	02/09/2017

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