Provider Demographics
NPI:1285011064
Name:REUTER, BRIAN ANDREW (MBBS)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:ANDREW
Last Name:REUTER
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6146 BOLLINGER RD # 700134
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-3068
Mailing Address - Country:US
Mailing Address - Phone:858-405-8349
Mailing Address - Fax:
Practice Address - Street 1:DAMERON HOSPITAL
Practice Address - Street 2:525 ACACIA ST
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95203
Practice Address - Country:US
Practice Address - Phone:858-405-8349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-30
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA150940207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine