Provider Demographics
NPI:1326130840
Name:REIMANN, TERRY ANN (MD)
Entity Type:Individual
Prefix:MRS
First Name:TERRY
Middle Name:ANN
Last Name:REIMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4655 VISTA DE ORO
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364
Mailing Address - Country:US
Mailing Address - Phone:818-704-9034
Mailing Address - Fax:
Practice Address - Street 1:5620 WILBUR
Practice Address - Street 2:AVE
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356
Practice Address - Country:US
Practice Address - Phone:818-345-0601
Practice Address - Fax:818-345-2061
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG41999207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G419990Medicaid
CA00G419990Medicaid
CAA89742Medicare UPIN