Provider Demographics
NPI:1831149335
Name:REESE, VAIL CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:VAIL
Middle Name:CHARLES
Last Name:REESE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:450 SUTTER ST
Mailing Address - Street 2:SUITE 830
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4206
Mailing Address - Country:US
Mailing Address - Phone:415-393-9550
Mailing Address - Fax:415-393-9556
Practice Address - Street 1:450 SUTTER ST
Practice Address - Street 2:SUITE #830
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4206
Practice Address - Country:US
Practice Address - Phone:415-362-2238
Practice Address - Fax:415-362-7745
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2008-03-19
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Provider Licenses
StateLicense IDTaxonomies
CAG 80000207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG07349Medicare UPIN