Provider Demographics
NPI:1528177706
Name:REED, JOHN BRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BRIAN
Last Name:REED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 J ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3631
Mailing Address - Country:US
Mailing Address - Phone:916-454-6191
Mailing Address - Fax:916-454-1036
Practice Address - Street 1:3939 J ST
Practice Address - Street 2:SUITE 106
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3631
Practice Address - Country:US
Practice Address - Phone:916-454-6191
Practice Address - Fax:916-454-1036
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG82260207W00000X, 207WX0107X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G822601OtherBLUE SHIELD
CA00G822600Medicaid
CAP00207900OtherRAILROAD MEDICARE
WA0199875OtherDEPT. OF LABOR WASHINGTON
CA00G822601Medicare PIN
CA00G822600Medicaid
CA00G822603Medicare PIN
CA00G822601OtherBLUE SHIELD
CAP00207900OtherRAILROAD MEDICARE
CA00G822606Medicare PIN
CA00G822604Medicare PIN