Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RR0500X | Rheumatology | MD194752 | OR |
Y | 2080P0216X | Pediatric Rheumatologist | A63957 | CA |
N | 2080P0216X | Pediatric Rheumatologist | MD194752 | OR |
NPI | 1255427365 |
---|---|
Provider Name | Andreas Otto Reiff |
First Address | Los Angeles, CA 90010-2804 |
Second Address | Los Angeles, CA 90027-6062 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 27/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A639570 | (05) | CA |
00A639570 G11 | CAL OPTIMA (01) | CA |
G72726 | (02) | CA |