Provider Demographics
NPI:1922074731
Name:REIER, ALICE CAROL (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:CAROL
Last Name:REIER
Suffix:
Gender:F
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:PO BOX 996
Mailing Address - Street 2:
Mailing Address - City:HAYDEN
Mailing Address - State:ID
Mailing Address - Zip Code:83835-0996
Mailing Address - Country:US
Mailing Address - Phone:208-664-4026
Mailing Address - Fax:855-532-5921
Practice Address - Street 1:3300 WEBSTER ST
Practice Address - Street 2:STE 900
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3156
Practice Address - Country:US
Practice Address - Phone:510-834-3700
Practice Address - Fax:510-834-5015
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-23
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG81697174400000X
IN01090098A207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G816970Medicaid
CA00G816970Medicare ID - Type Unspecified
CA00G816970Medicaid