Provider Demographics
NPI:1134173750
Name:REINHERZ, LANCE S (MD)
Entity type:Individual
Prefix:
First Name:LANCE
Middle Name:S
Last Name:REINHERZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25470 MEDICAL CENTER DR STE 105
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-4901
Mailing Address - Country:US
Mailing Address - Phone:951-698-4600
Mailing Address - Fax:951-514-2542
Practice Address - Street 1:25470 MEDICAL CENTER DR STE 105
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-4901
Practice Address - Country:US
Practice Address - Phone:951-698-4600
Practice Address - Fax:951-514-2542
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2024-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA86823207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A868230Medicaid
CAP00142337Medicare PIN
CAWA86823AMedicare PIN
I04227Medicare UPIN
CAP00638835Medicare PIN
CA00A868230Medicare PIN