Provider Demographics
NPI:1356928402
Name:JOSE K REYES MD INC
Entity type:Organization
Organization Name:JOSE K REYES MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:K
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-487-4007
Mailing Address - Street 1:1625 TULLY RD STE A
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95122-2541
Mailing Address - Country:US
Mailing Address - Phone:408-929-0606
Mailing Address - Fax:408-350-7319
Practice Address - Street 1:1625 TULLY RD STE A
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95122-2541
Practice Address - Country:US
Practice Address - Phone:408-929-0606
Practice Address - Fax:408-350-7319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-25
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty