Individual
DR. JEFFREY DEAN RIES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1310 SAN BERNARDINO RD, SUITE 101, UPLAND, CA 91786-4979
(909) 579-0779
(909) 579-0789
Mailing address
1310 SAN BERNARDINO RD, SUITE 101, UPLAND, CA 91786-4985
(909) 579-0779
(909) 579-0789
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20A5138
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00AX51380
—
CA
Enumeration date
04/10/2006
Last updated
07/27/2012
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