Individual
MARK A REILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3010 COLBY ST, 118, BERKELEY, CA 94705-2059
(510) 845-3856
(510) 845-1936
Mailing address
3010 COLBY ST, 118, BERKELEY, CA 94705-2059
(510) 845-3856
(510) 845-1936
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
G43696
CA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
G43696
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G436960
BLUE SHIELD
CA
05
—
00G436960
—
CA
01
—
G43696
STATE LICENSE
CA
Enumeration date
07/07/2006
Last updated
09/11/2025
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