Provider Information for 1316288954
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MELANIE REYES
Sex: Female
NPI: 1316288954
Last Updated: 2019-09-16
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1316288954 | ||||||||||||
| Enumeration Date | 2013-03-06 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 883 ORANGE, CA 92856-6883 United States Phone: 949-424-3717 | Fax: | ||||||||||||
| Primary Practice Address | 594 N GLASSELL ST ORANGE, CA 92867-6748 United States Phone: 949-424-3717 | Fax: | ||||||||||||
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