Individual
JEREMY HECTOR REYNOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
255 E RINCON ST, CORONA, CA 92879-1367
(951) 523-8509
(951) 221-8475
Mailing address
1621 MESA DR APT 19, NEWPORT BEACH, CA 92660-0111
(949) 259-3921
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
51014
CA
Other
Enumeration date
03/13/2021
Last updated
03/13/2021
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