Individual
MR. CARLO REYES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
71843 HIGHWAY 111 STE B, RANCHO MIRAGE, CA 92270-4418
(760) 610-5190
Mailing address
5236 GODINEZ DR, FONTANA, CA 92336-4624
(626) 806-9025
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
95015437
CA
363L00000X
Nurse Practitioner
95015437
CA
363LF0000X
Family Nurse Practitioner
Primary
95015437
CA
Other
Enumeration date
10/13/2020
Last updated
09/11/2024
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