Provider Demographics
NPI:1669727046
Name:REYNA, CHRISTIAN (DO)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:REYNA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 J ST
Mailing Address - Street 2:STE 370
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3671
Mailing Address - Country:US
Mailing Address - Phone:916-453-2800
Mailing Address - Fax:916-453-2804
Practice Address - Street 1:1820 J ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-3010
Practice Address - Country:US
Practice Address - Phone:916-737-5555
Practice Address - Fax:916-313-8452
Is Sole Proprietor?:No
Enumeration Date:2012-07-20
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10044206207R00000X
CA20A17415207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine