Individual
REGINALD SCOTT FAYSSOUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
39000 BOB HOPE DR, HARRY & DIANE RINKER BUILDING, RANCHO MIRAGE, CA 92270-3221
(760) 568-2684
(760) 341-5832
Mailing address
PO BOX 1730, RANCHO MIRAGE, CA 92270-1058
(760) 568-2684
(760) 837-2269
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
062501
GA
207XS0117X
Orthopaedic Surgery of the Spine Physician
062501
GA
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
A111590
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A11590
CA LICENSE
CA
Enumeration date
05/27/2008
Last updated
04/05/2023
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