Provider Demographics
NPI:1174576284
Name:EDWARD REECE MD A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:EDWARD REECE MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:REECE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:562-945-1679
Mailing Address - Street 1:8135 PAINTER AVE
Mailing Address - Street 2:SUITE 206
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-3158
Mailing Address - Country:US
Mailing Address - Phone:562-945-1679
Mailing Address - Fax:562-945-0172
Practice Address - Street 1:8135 PAINTER AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-3158
Practice Address - Country:US
Practice Address - Phone:562-945-1679
Practice Address - Fax:562-945-0172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG20799207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G207990Medicaid
CAA41077Medicare UPIN
CAG20799Medicare ID - Type Unspecified