Provider Demographics
NPI:1124288774
Name:SONNTAG REEVE MEDICAL CORP
Entity type:Organization
Organization Name:SONNTAG REEVE MEDICAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:REEVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-899-2244
Mailing Address - Street 1:460 W EAST AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-7203
Mailing Address - Country:US
Mailing Address - Phone:530-899-2244
Mailing Address - Fax:530-899-9331
Practice Address - Street 1:460 W EAST AVE STE 110
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-7203
Practice Address - Country:US
Practice Address - Phone:530-899-2244
Practice Address - Fax:530-899-2244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-16
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71540332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1296510001OtherDMERC
CASD0071540Medicaid
CASD0071540Medicaid
CA1296510001Medicare NSC