Individual
JOAN REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2125 OAK GROVE RD, SUITE 200, WALNUT CREEK, CA 94598-2536
(925) 296-7150
(925) 296-7171
Mailing address
2125 OAK GROVE RD, SUITE 200, WALNUT CREEK, CA 94598-2536
(925) 296-7150
(925) 296-7171
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G46213
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300039422
RAILROAD MEDICARE
CA
01
—
300047916
RAILROAD MEDICARE
CA
01
—
300104406
RAILROAD MEDICARE
CA
Enumeration date
06/22/2006
Last updated
04/02/2015
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