Provider Demographics
NPI:1174572572
Name:REINER, DAVID PHILIP (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:PHILIP
Last Name:REINER
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 1:1624 W OLIVE AVE
Mailing Address - Street 2:SUITE F
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2459
Mailing Address - Country:US
Mailing Address - Phone:818-843-2835
Mailing Address - Fax:818-843-3310
Practice Address - Street 1:1624 W OLIVE AVE
Practice Address - Street 2:SUITE F
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2459
Practice Address - Country:US
Practice Address - Phone:818-843-2835
Practice Address - Fax:818-843-3310
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80102174400000X, 2085R0202X, 2085N0700X
DEC1-00256772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
No174400000XOther Service ProvidersSpecialist
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA80102AMedicare PIN
CAI53075Medicare UPIN