Individual
MARIA LOURDES FERNANDEZ REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
6371 RANCHO MISSION RD, UNIT 2, SAN DIEGO, CA 92108-2016
(619) 988-2210
Mailing address
PO BOX 1592, LA JOLLA, CA 92038-1592
(619) 988-2210
(619) 280-4916
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A49139
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A49139
CALIFORNIA LICENSE
CA
Enumeration date
08/05/2007
Last updated
09/10/2012
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