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Individual

MICHAEL ANTHONY REBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1310 LAS TABLAS RD STE 103, TEMPLETON, CA 93465-9746
(805) 434-0829
(805) 928-9588
Mailing address
1310 LAS TABLAS RD STE 206, TEMPLETON, CA 93465-9747
(805) 461-7080
(805) 296-3566

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
04-25829
KS
2085R0202X
Diagnostic Radiology Physician
19365
OK
2085R0202X
Diagnostic Radiology Physician
Primary
G146743
CA

Other

Enumeration date
06/15/2006
Last updated
09/10/2025
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