Provider Demographics
NPI:1710272117
Name:REITZ, JAMES COYNE (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:COYNE
Last Name:REITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78939 SPIRITO CT
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-4016
Mailing Address - Country:US
Mailing Address - Phone:760-200-3699
Mailing Address - Fax:
Practice Address - Street 1:78939 SPIRITO CT
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-4016
Practice Address - Country:US
Practice Address - Phone:760-200-3699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC18291207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology