Provider Demographics
NPI:1821103730
Name:REYES, RAYMOND M (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:M
Last Name:REYES
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2101 COURAGE DR
Mailing Address - Street 2:BOX 4090, MAIL STATION 10-300
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-6717
Mailing Address - Country:US
Mailing Address - Phone:707-435-2080
Mailing Address - Fax:707-435-2103
Practice Address - Street 1:2101 COURAGE DR
Practice Address - Street 2:BOX 4090, MAIL STATION 10-300
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-6717
Practice Address - Country:US
Practice Address - Phone:707-435-2080
Practice Address - Fax:707-435-2103
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAC0502002084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry