Provider Demographics
NPI:1114125549
Name:MINKOWITZ, REUVEN B (MD)
Entity Type:Individual
Prefix:DR
First Name:REUVEN
Middle Name:B
Last Name:MINKOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 WEST AVE L
Mailing Address - Street 2:KAISER PERMANENTE ANTELOPE VALLEY
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534
Mailing Address - Country:US
Mailing Address - Phone:661-729-7100
Mailing Address - Fax:661-951-2795
Practice Address - Street 1:615 W AVENUE L
Practice Address - Street 2:KAISER PERMANENTE ANTELOPE VALLEY
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-7211
Practice Address - Country:US
Practice Address - Phone:661-729-7100
Practice Address - Fax:661-951-2795
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA99899174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist