Provider Demographics
NPI:1952479180
Name:REBEL, CYRIL WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:CYRIL
Middle Name:WILLIAM
Last Name:REBEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:550 EAST ALMOND AVENUE
Mailing Address - Street 2:SUITE A
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637
Mailing Address - Country:US
Mailing Address - Phone:559-661-0476
Mailing Address - Fax:559-673-4565
Practice Address - Street 1:550 EAST ALMOND AVENUE
Practice Address - Street 2:SUITE A
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637
Practice Address - Country:US
Practice Address - Phone:559-661-0476
Practice Address - Fax:559-673-4565
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA62819207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A628190Medicaid
CA00A628190Medicaid
CA00A628190Medicare ID - Type Unspecified