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Individual

MR. EDMOND CHAN REYES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
INDEPENDENT CORPSMAN

Contact information

Practice address
NAVAL AIR STATION NORTH ISLAND, BLDG 290, SANDIEGO, CA 92135
(619) 767-1496
(619) 767-1497
Mailing address
35755 CORAL DR, WINCHESTER, CA 92596
(951) 852-8530
(619) 767-1497

Taxonomy

Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
CA

Other

Enumeration date
12/01/2006
Last updated
07/08/2007
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