Provider Demographics
NPI:1578547576
Name:REINER, STEVEN C
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:C
Last Name:REINER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15201 11TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92395-3735
Mailing Address - Country:US
Mailing Address - Phone:818-895-3100
Mailing Address - Fax:442-229-6691
Practice Address - Street 1:15201 11TH ST STE 300
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92395-3735
Practice Address - Country:US
Practice Address - Phone:818-895-3100
Practice Address - Fax:442-229-6691
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2021-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYG27015207Q00000X
ORMD28462207Q00000X
CAG27015207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ZZZ92058ZOtherGROUP SITE LOCATION
1730180415OtherGROUP NPI
C08701Medicare UPIN
ORC08701Medicare UPIN
1730180415OtherGROUP NPI