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Organization
LYLE J REBER MD INC
Active
Organization
LYLE J REBER MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYLE J REBER MD (PRESIDENT)
(760) 625-1650
Entity
Organization
Contact information
Practice address
47110 WASHINGTON ST, SUITE 104, LA QUINTA, CA 92253-2186
(760) 625-1650
(760) 625-1654
Mailing address
PO BOX 6449, LA QUINTA, CA 92248-6449
(760) 625-1650
(760) 625-1654
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G68674
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063444578
NPI
—
01
—
G68674
STATE
CA
Enumeration date
04/23/2010
Last updated
04/23/2010
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