Provider Demographics
NPI:1073798237
Name:REINA, MARTIN ANDREW (RT (R) (MR))
Entity Type:Individual
Prefix:MR
First Name:MARTIN
Middle Name:ANDREW
Last Name:REINA
Suffix:
Gender:M
Credentials:RT (R) (MR)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:363 E BADILLO ST
Mailing Address - Street 2:
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-2208
Mailing Address - Country:US
Mailing Address - Phone:626-484-0202
Mailing Address - Fax:714-688-5559
Practice Address - Street 1:363 E BADILLO ST
Practice Address - Street 2:
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-2208
Practice Address - Country:US
Practice Address - Phone:626-484-0202
Practice Address - Fax:714-688-5559
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-07
Last Update Date:2008-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARHT 473232471M1202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471M1202XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistMagnetic Resonance Imaging