Individual
LYLE JONATHAN REBER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
47647 CALEO BAY DR, SUITE 200, LA QUINTA, CA 92253-8854
(760) 777-8282
(760) 771-9085
Mailing address
PO BOX 6449, LA QUINTA, CA 92248-6449
(760) 777-8282
(760) 771-9085
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G68674
CA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
G68674
CA
Other
Enumeration date
07/07/2006
Last updated
01/12/2011
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