Provider Demographics
NPI:1235253576
Name:REECE, EDWARD ALBERT JR (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ALBERT
Last Name:REECE
Suffix:JR
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 1:8135 PAINTER AVE
Mailing Address - Street 2:SUITE # 206
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-3102
Mailing Address - Country:US
Mailing Address - Phone:562-945-1679
Mailing Address - Fax:562-945-0172
Practice Address - Street 1:8135 PAINTER AVE
Practice Address - Street 2:SUITE # 206
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-3102
Practice Address - Country:US
Practice Address - Phone:562-945-1679
Practice Address - Fax:562-945-0172
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG20799207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G207990Medicaid
CA756111993OtherRAILROAD MEDICARE
CAA41077Medicare UPIN
CAG20799Medicare ID - Type Unspecified