Individual
IAN REILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9888 GENESEE AVE, LA JOLLA, CA 92037-1205
(858) 354-6049
Mailing address
9888 GENESEE AVE, LA JOLLA, CA 92037-1205
(858) 354-6049
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A76423
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A764230
—
CA
Enumeration date
03/08/2006
Last updated
12/03/2013
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