Individual
MARK THOMAS REIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
81 HIGHLAND SPRINGS AVE, SUITE 103, BEAUMONT, CA 92223-3170
(951) 845-0313
(360) 414-5758
Mailing address
PO BOX 10069, SAN BERNARDINO, CA 92423-0069
(909) 335-4188
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
00032312
WA
207X00000X
Orthopaedic Surgery Physician
Primary
G88836
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000258
—
OR
01
—
215163
LABOR & IND
WA
05
—
8467847
—
WA
01
—
8943021
CRIME VICTIMS
WA
01
—
FU515Z
MEDICARE
CA
Enumeration date
09/13/2006
Last updated
08/16/2016
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