# WILLIAM VAN DER REIS MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730419243
- **Authorized official:** DR. WILLIAM L VAN DER REIS MD (PRESIDENT)
- **Authorized official phone:** (949) 661-2423

## Contact information

- **Practice address:** 653 CAMINO DE LOS MARES, SUITE 109, SAN CLEMENTE, CA 92673-2808
- **Practice address phone:** (949) 661-2423
- **Practice address fax:** (949) 661-9205
- **Mailing address:** 653 CAMINO DE LOS MARES, SUITE 109, SAN CLEMENTE, CA 92673-2808
- **Mailing address phone:** (949) 661-2423
- **Mailing address fax:** (949) 661-9205

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | G81476 | CA | Yes |

## Other

- **Enumeration date:** 01/05/2010
- **Last updated:** 04/27/2010