Individual
DR. JOAN MENDEN REESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4355 RUFFIN RD, SAN DIEGO, CA 92123-4306
(858) 576-2973
(858) 496-4303
Mailing address
4355 RUFFIN RD, SAN DIEGO, CA 92123-4306
(858) 576-2973
(858) 496-4303
Taxonomy
Speciality
Code
Description
License number
State
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
G45782
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CMS200039
CCS GHPP PROVIDER NUMBER
CA
Enumeration date
03/16/2007
Last updated
07/08/2007
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