Individual
PETER MCLEAN REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4140 JADE ST, SUITE 100, CAPITOLA, CA 95010-3956
(831) 475-4024
(831) 475-4344
Mailing address
3803 S BASCOM AVE, SUITE 102, CAMPBELL, CA 95008-7317
(831) 475-4024
(831) 475-4344
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
C384340
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C384340
MEDICAL LIC
CA
Enumeration date
08/15/2006
Last updated
01/15/2014
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