Provider Demographics
NPI:1720061112
Name:REEN, AMIKJIT SINGH (MD)
Entity Type:Individual
Prefix:
First Name:AMIKJIT
Middle Name:SINGH
Last Name:REEN
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 1:1525 N NORMA ST STE B
Mailing Address - Street 2:
Mailing Address - City:RIDGECREST
Mailing Address - State:CA
Mailing Address - Zip Code:93555-6536
Mailing Address - Country:US
Mailing Address - Phone:760-463-1613
Mailing Address - Fax:760-463-1614
Practice Address - Street 1:1525 N NORMA ST STE B
Practice Address - Street 2:
Practice Address - City:RIDGECREST
Practice Address - State:CA
Practice Address - Zip Code:93555-6536
Practice Address - Country:US
Practice Address - Phone:760-463-1613
Practice Address - Fax:760-463-1614
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA91581207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CL440YOtherPTAN