Individual
DR. MARC A REINOSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
147 N BRENT ST, VENTURA, CA 93003-2809
(805) 652-5018
(805) 648-6170
Mailing address
147 N BRENT ST, VENTURA, CA 93003-2809
(805) 652-5018
(805) 648-6170
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
G77260
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050394
BLUE CROSS
CA
01
—
95-1683892
OTHER INSURANCE
CA
01
—
G77260
LICENSE NUMBER
CA
05
—
HSC30394F
—
CA
05
—
ZZT40394F
—
CA
01
—
ZZZ53994Z
BLUE SHIELD
CA
01
—
ZZZA56032
BLUE SHIELD
CA
Enumeration date
09/20/2006
Last updated
10/23/2013
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