Organization
ALFRED J REYNAUD
Active
Other names
Medical Specialty Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
ALFRED J REYNAUD (OWNER)
(510) 839-4829
Entity
Organization
Contact information
Practice address
2929 SUMMIT ST, #208, OAKLAND, CA 94609
(510) 839-4829
Mailing address
PO BOX 27146, SAN FRANCISCO, CA 94127
(510) 839-4829
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF2773
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZZ59174Z
—
CA
Enumeration date
05/07/2007
Last updated
08/22/2020
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