Provider Demographics
NPI:1740965912
Name:REYES, ROCAEL (CHIROPRACTIC)
Entity type:Individual
Prefix:
First Name:ROCAEL
Middle Name:
Last Name:REYES
Suffix:
Gender:M
Credentials:CHIROPRACTIC
Other - Prefix:
Other - First Name:ROCAEL
Other - Middle Name:
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1879 E JAY ST
Mailing Address - Street 2:B
Mailing Address - City:ONTARIO
Mailing Address - State:CALIFORNIA
Mailing Address - Zip Code:91764
Mailing Address - Country:SV
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1879 E JAY ST
Practice Address - Street 2:B
Practice Address - City:ONTARIO
Practice Address - State:CALIFORNIA
Practice Address - Zip Code:91764
Practice Address - Country:SV
Practice Address - Phone:909-236-2734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174200000XOther Service ProvidersMeals