Provider Demographics
NPI:1033228382
Name:REYES, ATMAN R (MD)
Entity Type:Individual
Prefix:
First Name:ATMAN
Middle Name:R
Last Name:REYES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5353 TOPANGA CANYON BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1737
Mailing Address - Country:US
Mailing Address - Phone:818-704-1579
Mailing Address - Fax:818-704-8790
Practice Address - Street 1:5353 TOPANGA CANYON BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1737
Practice Address - Country:US
Practice Address - Phone:818-704-1579
Practice Address - Fax:818-704-8790
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-06-18
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Provider Licenses
StateLicense IDTaxonomies
CAA652932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A652930Medicaid
H33534Medicare UPIN
A65293Medicare ID - Type Unspecified