Provider Demographics
NPI:1902816135
Name:REYES, MICHELLE ELIZABETH (MD)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ELIZABETH
Last Name:REYES
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Gender:F
Credentials:MD
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Mailing Address - Street 1:7301 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 410
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91307-1904
Mailing Address - Country:US
Mailing Address - Phone:818-340-9960
Mailing Address - Fax:818-340-5650
Practice Address - Street 1:7301 MEDICAL CENTER DR
Practice Address - Street 2:SUITE410
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91307-1904
Practice Address - Country:US
Practice Address - Phone:818-340-9960
Practice Address - Fax:818-340-5650
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2010-02-23
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Provider Licenses
StateLicense IDTaxonomies
CAG078285207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG45539Medicare UPIN