Provider Demographics
NPI:1942380787
Name:REY, ROBERTO (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERTO
Middle Name:
Last Name:REY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:435 N BEDFORD DR PH
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4316
Mailing Address - Country:US
Mailing Address - Phone:310-205-3107
Mailing Address - Fax:310-205-8822
Practice Address - Street 1:450 N ROXBURY DR STE 400
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4218
Practice Address - Country:US
Practice Address - Phone:310-205-3107
Practice Address - Fax:310-205-8855
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL131200208200000X
CAG076688208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery