Provider Demographics
NPI:1700893294
Name:REYNOLDS, STEVEN H (DO)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:H
Last Name:REYNOLDS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5977 E. SPRING ST.
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808
Mailing Address - Country:US
Mailing Address - Phone:562-421-3727
Mailing Address - Fax:562-420-8948
Practice Address - Street 1:5865 E NAPLES PLZ
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803-5040
Practice Address - Country:US
Practice Address - Phone:562-434-4481
Practice Address - Fax:562-434-5713
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A6475207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP01391232OtherRR MEDICARE
CAP01391232OtherRR MEDICARE
G09653Medicare UPIN