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Individual

ERICSON P REYES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3300 E SOUTH ST STE 308, LAKEWOOD, CA 90805-4598
(562) 630-3111
(562) 630-3107
Mailing address
PO BOX 879, LAKEWOOD, CA 90714-0879
(562) 630-3111
(562) 630-3107

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP15834
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
515085
RN LICENSE
CA
01
NP15834
NURSE PRACTITIONER LICENS
CA
Enumeration date
08/25/2006
Last updated
10/10/2023
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