Organization Name: | JOHN S. REYNARD, JR., M.D., INC. |
NPI Number: | 1649475146 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOHN S. REYNARD (PRES) |
Mailing Address: | 31862 Coast Hwy Ste 203 Laguna Beach |
State: | CA US |
Postal Code: | 926516769 |
Phone Number: | 9494994538 |
Fax Number: | 9516740918 |
NPI Enumeration Date: | 06/15/2007 |
NPI Last Update Date: | 11/01/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | G12598 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |