Provider Demographics
NPI:1467604090
Name:ATMAN REYES MD INC
Entity Type:Organization
Organization Name:ATMAN REYES MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ATMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-704-1579
Mailing Address - Street 1:5353 TOPANGA CANYON BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-1737
Mailing Address - Country:US
Mailing Address - Phone:818-704-1579
Mailing Address - Fax:818-704-8790
Practice Address - Street 1:5353 TOPANGA CANYON BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1737
Practice Address - Country:US
Practice Address - Phone:818-704-1579
Practice Address - Fax:818-704-8790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA652932084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty