Individual
LAURIE REYNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
530 WILSHIRE BLVD STE 202B, SANTA MONICA, CA 90401-1427
(310) 453-1266
(310) 453-1426
Mailing address
2118 WILSHIRE BLVD # 614, SANTA MONICA, CA 90403-5704
(310) 453-1266
(310) 453-1426
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
G40794
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DA6447
RAILROAD MEDICARE
CA
01
—
M050376
HARBOR- UCLA
CA
Enumeration date
06/16/2005
Last updated
02/12/2018
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