Individual
JEFFREY CRAIG REBISH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
859 E FOOTHILL BLVD STE B, UPLAND, CA 91786-4085
(909) 981-8929
(909) 946-9740
Mailing address
859 E FOOTHILL BLVD STE B, UPLAND, CA 91786-4085
(909) 981-8929
(909) 946-9740
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A76057
CA
207ND0101X
MOHS-Micrographic Surgery Physician
A76057
CA
207ND0900X
Dermatopathology Physician
A76057
CA
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
S76057
CA
207NP0225X
Pediatric Dermatology Physician
A76057
CA
207NS0135X
Procedural Dermatology Physician
A76057
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A760571
PTAN
CA
Enumeration date
09/27/2006
Last updated
10/15/2010
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