Provider Demographics
NPI:1396746707
Name:REICHNER, DANIEL RICHARD II (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:RICHARD
Last Name:REICHNER
Suffix:II
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 1:1310 W STEWART DR
Mailing Address - Street 2:SUITE 303
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-3854
Mailing Address - Country:US
Mailing Address - Phone:714-997-5200
Mailing Address - Fax:714-997-5222
Practice Address - Street 1:1310 W STEWART DR
Practice Address - Street 2:SUITE 303
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-3854
Practice Address - Country:US
Practice Address - Phone:714-997-5200
Practice Address - Fax:714-997-5222
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA55086174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1515034OtherMEDI-CAL UPIN NUMBER
CA00A550860Medicaid
CABR5024257OtherDEA NUMBER
CAH45415Medicare UPIN
CA00A550860Medicaid