Individual
MR. RICHARD WILLIAM REIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
400 NORTH PEPPER AVENUE 2ND FLOOR, ANESTHESIA DEPT., INLAND EMPIRE ANESTHESIA MEDICAL GROUP, INC., COLTON, CA 92324-0765
(909) 580-2440
(909) 580-2441
Mailing address
PO BOX 765, COLTON, CA 92324-0800
(909) 889-7084
(909) 889-7034
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
NA716
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
NA716
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430079039
RAILROAD MEDICARE
—
05
—
RN3139800
—
CA
Enumeration date
12/13/2005
Last updated
06/03/2013
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