Provider Demographics
NPI:1346690518
Name:VALENCIA, REIMUS (DO)
Entity Type:Individual
Prefix:
First Name:REIMUS
Middle Name:
Last Name:VALENCIA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6970 E CHAUNCEY LN STE 100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85054-5158
Mailing Address - Country:US
Mailing Address - Phone:602-788-7211
Mailing Address - Fax:602-788-1890
Practice Address - Street 1:6970 E CHAUNCEY LN STE 100
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85054-5158
Practice Address - Country:US
Practice Address - Phone:602-788-7211
Practice Address - Fax:602-788-1890
Is Sole Proprietor?:No
Enumeration Date:2016-06-17
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.014067207RA0201X
MI50101022350207R00000X
AZ010358207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine