Individual
REYNALDO L REYES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
35000 GUADALCANAL ST, BRANCH MEDICAL CLINIC MARINE CORPS RECRUIT DEPOT, SAN DIEGO, CA 92140
(619) 532-4056
Mailing address
12497 CONQUISTADOR WAY, SAN DIEGO, CA 92128-2152
(858) 603-3106
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
363AM0700X
Medical Physician Assistant
58601
CA
Other
Enumeration date
04/13/2006
Last updated
09/22/2022
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